scholarly journals Metabolic profiles differences of overweight patients on olanzapine, clozapine and risperidone

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S247-S248
Author(s):  
Siew Fai Liew ◽  
Gupta Bhanu ◽  
Jimmy Lee ◽  
Kok Seng Chee ◽  
Li Qi Neo ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Atypical Antipsychotics ◽  
Fasting Blood Glucose ◽  
Metabolic Profiles ◽  
Metabolic Abnormalities ◽  
Long Term Effects ◽  
Serum Triglycerides ◽  
Significant Difference ◽  
Clinically Significant ◽  
Definition Of

AimsWe set out to examine the differences in metabolic profiles of at risk (overweight) patients across commonly used atypical antipsychotics (Olanzapine, Risperidone, Clozapine). We hypothesized that Olanzapine and Clozapine group will have more metabolic abnormalities compared to Risperidone.BackgroundCardiovascular diseases remain the leading cause of morbidity and mortality among people with schizophrenia. Since the introduction of atypical antipsychotics, there is cumulative evidence of their association with metabolic abnormalities. Clozapine and Olanzapine are known to constitute the highest metabolic risks amongst atypical antipsychotics.MethodThis study is based on the data of 67 subjects recruited into a 12-week open-labelled trial looking at the effects of adjunctive Aripiprazole in atypical antipsychotics for weight reduction and improvement in metabolic profile. Metabolic profiles including weight, waist circumference, fasting blood glucose, HbA1c, serum total, HDL and LDL cholesterol levels and triglycerides were measured at baseline. The measurements were then compared across the different subgroups of atypical antipsychotics. The definition of metabolic syndrome proposed by the Third Report of the National Cholesterol Education Program Expert Panel (Adults Treatment Panel III) was used.ResultThe atypical antipsychotics were grouped into Olanzapine (n = 27), Risperidone (n = 24) and Clozapine (n = 16). More than 50% of clozapine-treated and Olanzapine-treated overweight patients were demonstrated to have metabolic syndrome at baseline. There was a statistically significant difference in serum triglycerides (p = 0.012), LDL (p = 0.046) and HbA1c (p = 0.045) across the three groups as demonstrated by one-way ANOVA. A Tukey post hoc test showed that both the Olanzapine (p = 0.032) and Risperidone (p = 0.013) groups demonstrated statistically significant lower serum triglycerides when compared to Clozapine. Interestingly, the mean serum HbA1c was significantly lower in Clozapine when compared to Olanzapine group (p = 0.045), perhaps reflecting the closer monitoring of fasting blood sugar in clozapine patients. When controlled for age and BMI, the significant differences in serum triglycerides remain between Clozapine and Risperidone groups [but not for serum HbA1c]. There were no statistically significant differences across the groups with respect to other metabolic parameters.ConclusionAt baseline, metabolic dysregulation was demonstrated in all subgroups of overweight patients. As hypothesized, patients on Olanzapine and Clozapine groups fared worse than Risperidone. Further studies examining long term effects of atypical antipsychotics in a larger sample of patients are warranted to confirm these findings. These findings have clinical significance in terms of choosing the first antipsychotic for drug naïve patients or where there is no clinically significant difference in efficacy.

scholarly journals Metabolic profiles differences of overweight patients on olanzapine, clozapine and risperidone

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S248-S248
Author(s):  
Siew Fai Liew ◽  
Gupta Bhanu ◽  
Charmaine Tang ◽  
Jimmy Lee ◽  
Kok Seng Chee ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Atypical Antipsychotics ◽  
Fasting Blood Glucose ◽  
Metabolic Profiles ◽  
Metabolic Abnormalities ◽  
Long Term Effects ◽  
Serum Triglycerides ◽  
Significant Difference ◽  
Clinically Significant ◽  
Definition Of

AimsWe set out to examine the differences in metabolic profiles of at risk (overweight) patients across commonly used atypical antipsychotics (Olanzapine, Risperidone, Clozapine). We hypothesized that Olanzapine and Clozapine group will have more metabolic abnormalities compared to Risperidone.BackgroundCardiovascular diseases remain the leading cause of morbidity and mortality among people with schizophrenia. Since the introduction of atypical antipsychotics, there is cumulative evidence of their association with metabolic abnormalities. Clozapine and Olanzapine are known to constitute the highest metabolic risks amongst atypical antipsychotics.MethodThis study is based on the data of 67 subjects recruited into a 12-week open-labelled trial looking at the effects of adjunctive Aripiprazole in atypical antipsychotics for weight reduction and improvement in metabolic profile. Metabolic profiles including weight, waist circumference, fasting blood glucose, HbA1c, serum total, HDL and LDL cholesterol levels and triglycerides were measured at baseline. The measurements were then compared across the different subgroups of atypical antipsychotics. The definition of metabolic syndrome proposed by the Third Report of the National Cholesterol Education Program Expert Panel (Adults Treatment Panel III) was used.ResultThe atypical antipsychotics were grouped into Olanzapine (n = 27), Risperidone (n = 24) and Clozapine (n = 16). More than 50% of clozapine-treated and Olanzapine-treated overweight patients were demonstrated to have metabolic syndrome at baseline. There was a statistically significant difference in serum triglycerides (p = 0.012), LDL (p = 0.046) and HbA1c (p = 0.045) across the three groups as demonstrated by one-way ANOVA. A Tukey post hoc test showed that both the Olanzapine (p = 0.032) and Risperidone (p = 0.013) groups demonstrated statistically significant lower serum triglycerides when compared to Clozapine. Interestingly, the mean serum HbA1c was significantly lower in Clozapine when compared to Olanzapine group (p = 0.045), perhaps reflecting the closer monitoring of fasting blood sugar in clozapine patients. When controlled for age and BMI, the significant differences in serum triglycerides remain between Clozapine and Risperidone groups [but not for serum HbA1c]. There were no statistically significant differences across the groups with respect to other metabolic parameters.ConclusionAt baseline, metabolic dysregulation was demonstrated in all subgroups of overweight patients. As hypothesized, patients on Olanzapine and Clozapine groups fared worse than Risperidone. Further studies examining long term effects of atypical antipsychotics in a larger sample of patients are warranted to confirm these findings. These findings have clinical significance in terms of choosing the first antipsychotic for drug naïve patients or where there is no clinically significant difference in efficacy.

scholarly journals ASSOCIATION BETWEEN SERUM URIC ACID AND METABOLIC SYNDROME

2018 ◽  
Vol 11 (10) ◽  
pp. 400 ◽  
Author(s):  
Thaslima Nandhini Js ◽  
Savitha Basker G ◽  
Vishnupriya V
Keyword(s):  
Metabolic Syndrome ◽  
Uric Acid ◽  
Venous Blood ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Serum Triglycerides ◽  
Significant Difference ◽  
Disease Condition ◽  
Student’S T ◽  
Student’S T Test

Objective: Metabolic syndrome is a cluster of disease condition characterized by truncal obesity, hypertriglyceridemia, elevated blood pressure, and insulin resistance. An excessive circulating uric acid (UA) level even within normal range is always comorbid with metabolic syndrome and its components. The aim of the current study was to investigate the association between metabolic syndrome and serum UA level.Methods: A total of 60 subjects were divided into two groups of healthy (30 individuals) and metabolic syndrome patients (30 individuals) from dental outpatient department of Saveetha Dental College and Hospitals. 5 ml of fasting venous blood was collected in the plain collection tubes and centrifuged, and then serum was separated. Then, the serum was used to analyze the fasting blood glucose, serum triglycerides (TGLs), and serum UA by GOD-POD, enzymatic colorimetric, and uricase method, respectively. A statistical analysis was performed using Student’s t-test. p<0.05 was considered to be statistically significant.Result: Mean body mass index (BMI), fasting blood sugar (FBS), TGL, and UA level of control group were 23.36±1.81, 84.45±13.1, 110.9±22.6, and 3.48±1.21 respectively. Mean BMI, FBS, TGL, and UA level of study group were 35.24±3.04, 122.85±23.3, 212.1±39.6 and 9.08±2.63 respectively. There is a significant difference between these two groups with p<0.0001.Conclusion: This study showed that those individuals with metabolic syndrome have higher UA level that indicates hyperuricemia which is a significant predictor of metabolic syndrome.

scholarly journals Cholesterol Transporters ABCA1 and ABCG1 Gene Expression in Peripheral Blood Mononuclear Cells in Patients with Metabolic Syndrome

Cholesterol ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Zahra Tavoosi ◽  
Hemen Moradi-Sardareh ◽  
Massoud Saidijam ◽  
Reza Yadegarazari ◽  
Shiva Borzuei ◽  
...  
Keyword(s):  
Gene Expression ◽  
Metabolic Syndrome ◽  
Mononuclear Cells ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Regulation Mechanism ◽  
Healthy Individuals ◽  
Peripheral Blood Mononuclear ◽  
Significant Difference ◽  
Abca1 Expression

ABCA1 and ABCG1 genes encode the cholesterol transporter proteins that play a key role in cholesterol and phospholipids homeostasis. This study was aimed at evaluating and comparing ABCA1 and ABCG1 genes expression in metabolic syndrome patients and healthy individuals. This case-control study was performed on 36 patients with metabolic syndrome and the same number of healthy individuals in Hamadan (west of Iran) during 2013-2014. Total RNA was extracted from mononuclear cells and purified using RNeasy Mini Kit column. The expression of ABCA1 and ABCG1 genes was performed by qRT-PCR. Lipid profile and fasting blood glucose were measured using colorimetric procedures. ABCG1 expression in metabolic syndrome patients was significantly lower (about 75%) compared to that of control group, while for ABCA1 expression, there was no significant difference between the two studied groups. Comparison of other parameters such as HDL-C, FBS, BMI, waist circumference, and systolic and diastolic blood pressure between metabolic syndrome patients and healthy individuals showed significant differences (P<0.05). Decrease in ABCG1 expression in metabolic syndrome patients compared to healthy individuals suggests that hyperglycemia, related metabolites, and hyperlipidemia over the transporter capacity resulted in decreased expression of ABCG1. Absence of a significant change in ABCA1 gene expression between two groups can indicate a different regulation mechanism for ABCA1 expression.

scholarly journals Mouse breast cancer model-dependent changes in metabolic syndrome-associated phenotypes caused by maternal dioxin exposure and dietary fat

2009 ◽  
Vol 296 (1) ◽  
pp. E203-E210 ◽  
Author(s):  
Michele La Merrill ◽  
David S. Baston ◽  
Michael S. Denison ◽  
Linda S. Birnbaum ◽  
Daniel Pomp ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Adipose Tissue ◽  
Blood Glucose ◽  
Estrogenic Activity ◽  
Fasting Blood Glucose ◽  
Growth Spurt ◽  
Cancer Model ◽  
Serum Triglycerides ◽  
Cancer Models

Diets high in fat are associated with increased susceptibility to obesity and metabolic syndrome. Increased adipose tissue that is caused by high-fat diets (HFD) results in altered storage of lipophilic toxicants like 2,3,7,8-tetrachlorodibenzo- p-dioxin (TCDD), which may further increase susceptibility to metabolic syndrome. Because both TCDD and HFD are associated with increased breast cancer risk, we examined their effects on metabolic syndrome-associated phenotypes in three mouse models of breast cancer: 7,12-dimethylbenz[a]anthracene (DMBA), Tg(MMTV-Neu)202Mul/J (HER2), and TgN(MMTV-PyMT)634Mul/J (PyMT), all on an FVB/N genetic background. Pregnant mice dosed with 1 μg/kg of TCDD or vehicle on gestational day 12.5 were placed on a HFD or low-fat diet (LFD) at parturition. Body weights, percent body fat, and fasting blood glucose were measured longitudinally, and triglycerides were measured at study termination. On HFD, all cancer models reached the pubertal growth spurt ahead of FVB controls. Among mice fed HFD, the HER2 model had a greater increase in body weight and adipose tissue from puberty through adulthood compared with the PyMT and DMBA models. However, the DMBA model consistently had higher fasting blood glucose levels than the PyMT and HER2 models. TCDD only impacted serum triglycerides in the PyMT model maintained on HFD. Because the estrogenic activity of the HFD was three times lower than that of the LFD, differential dietary estrogenic activities did not drive the observed phenotypic differences. Rather, the HFD-dependent changes were cancer model dependent. These results show that cancer models can have differential effects on metabolic syndrome-associated phenotypes even before cancers arise.

scholarly journals Heritability of the risk factors characteristic for the metabolic syndrome: a twin study

2011 ◽  
Vol 152 (32) ◽  
pp. 1265-1271 ◽  
Author(s):  
György Jermendy ◽  
Levente Littvay ◽  
Rita Steinbach ◽  
Ádám Jermendy ◽  
Ádám Tárnoki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Environmental Factors ◽  
Fasting Blood Glucose ◽  
Hdl Cholesterol ◽  
Anthropometric Parameters ◽  
Serum Triglycerides ◽  
The Metabolic Syndrome ◽  
Genetic And Environmental Factors

Both genetic and environmental factors play role in the pathogenesis of the metabolic syndrome. The magnitude of genetic and environmental influences on the components of metabolic syndrome may vary in different populations. Aims: The present study was aimed to determine the effects of genetic and environmental factors on risk factors characteristic for the metabolic syndrome. Methods: A total of 101 (63 monozygotic and 38 dizygotic) adult twin pairs (n = 202; mean age: 43.3±15.8 years) were investigated. Medical history was recorded and physical examination was carried out for each subject. Fasting venous blood samples were used for measuring laboratory parameters. The presented estimates include the heritability structural equation (A-C-E) model results. In Model-1, all presented parameters are age- and gender- corrected. In Model-2, parameters were corrected for age, gender, body mass index and waist circumference. Results: Heritability in waist circumference (as well as in other anthropometric parameters such as weight and height) was high (Model-1: 71.0–88.1%). Similarly, genetic factors had the highest proportion of total phenotypic variance in systolic and diastolic blood pressure (Model-2: 57.1% and 57.7%, respectively). Based on the results of Model-2, unique environmental factors dominate alterations in serum triglycerides values (55.9%) while shared environmental factors proved to be substantial in alterations of HDL-cholesterol and fasting blood glucose values (58.1% and 57.1%, respectively). Comparing the results of Model-1 and Model-2, the difference in A-C-E model varied from 0.0% to 17.1%, indicating that only a minor proportion of genetic and environmental influences can be explained by the effects of anthropometric parameters. Conclusions: Among adult Hungarian healthy people, genetic factors have substantial influence on waist circumference and blood pressure values while environmental factors dominate alterations in serum triglycerides, HDL-cholesterol and fasting blood glucose values. The different heritability of individual risk factors challenges the original unifying concept of the metabolic syndrome. The results may be useful for establishing and implementing primary cardiovascular prevention both at individual and population levels. Orv. Hetil., 2011, 152, 1265–1271.

scholarly journals Monitoring the metabolic side-effects of atypical antipsychotics

2010 ◽  
Vol 34 (9) ◽  
pp. 390-395 ◽  
Author(s):  
Rohit Gumber ◽  
Mizrab Abbas ◽  
Manjunath Minajagi
Keyword(s):  
Primary Care ◽  
Metabolic Profile ◽  
Atypical Antipsychotics ◽  
Clinical Implications ◽  
Metabolic Profiles ◽  
Metabolic Abnormalities ◽  
Potential Value ◽  
Number Of Patients ◽  
Risk Patients ◽  
Audit Cycle

Aims and methodNational clinical guidance states that patients on antipsychotics should have their metabolic profile regularly monitored. The aim of this study was to assess whether we are effectively monitoring metabolic profiles and to improve the detection, communication and intervention of metabolic abnormalities among patients on atypical antipsychotics. We describe a full audit cycle.ResultsThe audit resulted in a 24% increase in the number of patients on atypical antipsychotics being referred to the metabolic clinic. The number of abnormal results communicated to primary care showed a significant improvement of 25% (P <0.001), and ultimately the number of patients who received intervention improved by 17% (P = 0.001).Clinical implicationsAudit feedback has been effective in changing clinical practice. The audit demonstrated the potential value of a metabolic clinic and shared care between primary and secondary practitioners for this group of high-risk patients.

Acute and long-term effects of grape and pomegranate juice consumption on vascular reactivity in paediatric metabolic syndrome

2010 ◽  
Vol 20 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Mohammad Hashemi ◽  
Roya Kelishadi ◽  
Mahin Hashemipour ◽  
Afshin Zakerameli ◽  
Noushin Khavarian ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Endothelial Function ◽  
Grape Juice ◽  
Pomegranate Juice ◽  
Controlled Clinical Trial ◽  
Flow Mediated Dilation ◽  
Long Term Effects ◽  
Daily Consumption ◽  
Significant Difference

AbstractObjectivesThis study, which to the best of our knowledge is the first of its kind, aimed to determine the acute and long-term effects of the consumption of grape and pomegranate juices on endothelium function in adolescents with metabolic syndrome, and to compare the effects of these two kinds of juices.MethodsThis randomised controlled clinical trial was conducted in 2008 among 30 adolescents, aged 12–15 years, with metabolic syndrome. Participants were randomly assigned to two groups of equal number; one group was asked to drink 18 millilitre per kilogram per day of natural grape juice and the other group was asked to drink 240 millilitre per day of natural pomegranate juice once daily for 1 month. Juices were homemade without any added sweetener. Basal brachial artery dimension and flow-mediated dilation as an index of endothelial function and endothelial-dependent dilation after receiving nitoglycerin spray were evaluated by high-resolution B mode ultrasonography before juice consumption, 4 hours and 30 days after regular daily consumption.ResultsFlow-mediated dilation at 90 seconds and after nitoglycerin significantly improved at 4 hours and at 1 month after drinking both kinds of juices, without significant difference between the two groups. The change at 1 month versus 4 hours was significant only in the grape juice group.ConclusionDaily consumption of diets rich in antioxidants might improve endothelial function in adolescents with metabolic syndrome. These effects began as soon as 4 hours after juice consumption. Such beneficial effects should be considered in dietary recommendations for the paediatric age group, notably in obese individuals.

scholarly journals Prevalence and Risk Factors of Metabolic Syndrome Among Teaching Staff of Engineering Colleges in Central India

2020 ◽  
Vol 3 (2) ◽  
pp. 8-16
Author(s):  
Sanjay Agrawal ◽  
Sanjeev M. Chaudhary ◽  
Sanjay S. Kubde ◽  
Manjusha Dhoble ◽  
Moin Shaikh
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Fasting Blood Glucose ◽  
Frozen Shoulder ◽  
Central India ◽  
High Density Lipoproteins ◽  
Teaching Staff ◽  
Serum Triglycerides ◽  
Strenuous Physical Activity ◽  
Sedentary Life Style

Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.

scholarly journals Incidence of Corrected QT Prolongation With Concomitant Methadone and Atypical Antipsychotics in Critically Ill Children

2021 ◽  
Vol 26 (3) ◽  
pp. 271-276
Author(s):  
Kaitlin M. Hughes ◽  
Anne Thorndyke ◽  
Emma M. Tillman
Keyword(s):  
Atypical Antipsychotic ◽  
Atypical Antipsychotics ◽  
Pilot Trial ◽  
Critically Ill Children ◽  
Qtc Interval ◽  
Qtc Prolongation ◽  
Significant Difference ◽  
Before And After ◽  
Observational Cohort ◽  
Clinically Significant

OBJECTIVE To evaluate the safety of the combination of methadone and an atypical antipsychotic in PICU patients. METHODS This was a retrospective observational cohort pilot study in a single-center PICU in an academic children's hospital. Children 1 month to 18 years of age were included if they received methadone, were then initiated on an atypical antipsychotic (i.e., quetiapine or risperidone), and had EKG monitoring before and after medication initiation. RESULTS Prolongation of the corrected QT (QTc) interval occurred in 5 of the 34 included patients when an atypical antipsychotic was added to methadone. Of the 5 patients who had a prolonged QTc interval, 4 (80%) were older than 12 years and had a median weight of 91.3 kg. There were statistical differences between age and weight when comparing patients who experienced QTc prolongation, but no differences in sex, ethnicity, electrolyte deficiencies, number of additional QTc-prolonging medications, and number of additional drug-drug interactions were identified. When comparing atypical antipsychotics, 9.5% of patients receiving risperidone had a prolonged QTc interval, versus 23% of patients receiving quetiapine (p = 0.04). The net change in QTc interval after initiation of methadone was 0.19 milliseconds (IQR: −3, 15), which increased after atypical antipsychotic initiation to 4 milliseconds (IQR: −16, 15). CONCLUSIONS Our pilot trial suggests there is no clinically significant difference in incidence of QTc prolongation with addition of atypical antipsychotics to methadone.

scholarly journals Metabolic Syndrome as the First Stage of Eldership; the Beginning of Real Aging

2021 ◽  
Author(s):  
Alexander V. Panov ◽  
Marina A. Darenskaya ◽  
Sergey I. Dikalov ◽  
Sergey I. Kolesnikov
Keyword(s):  
Metabolic Syndrome ◽  
Free Radical ◽  
Visceral Obesity ◽  
High Serum ◽  
Serum Triglycerides ◽  
Free Radical Theory ◽  
Radical Theory ◽  
Obesity Hypertension ◽  
Number Of Publications ◽  
Definition Of

The history of active worldwide scientific research on mechanisms of aging and the age-associated diseases counts more than five decades. Of these, among the numerous theories of aging, at least 50 years dominated the free radical theory of aging. Since mitochondria were found to be the major producers of free radicals, the research on aging became largely centered on mitochondria. At the end of 80s of the 20th century, physicians have established a new nosological entity named “Metabolic syndrome” comprising several simultaneously existing symptoms and risk factors, which increase with age to 47% in men and 64% for women. The diagnosis of metabolic syndrome (MetS) requires simultaneous presence of at least three out of five medical conditions: visceral obesity, hypertension, high blood sugar, insulin resistance, low serum high-density lipoprotein accompanied with high serum triglycerides. However, from the beginning of the definition of MetS there was, and still is, a rather lovely debate, which of the symptoms must be considered as the main one. In spite of the enormous number of publications on both mechanisms of aging and MetS, there was relatively small progress in understanding the fundamental processes in these closely related problems. On the contrary, the mitochondrial free radical theory was found to be wrong in its current paradigms. In this Chapter we will discuss recent discoveries and hypotheses which open new perspectives in both theoretical and practical approaches to the problems of aging and MetS. We will show how aging and development of MetS are closely related to each other and the normal ontogenesis of human beings. Why men and women have different rates of aging and mechanisms of transition to MetS. We state that MetS is not just a cluster of symptoms, but one of the last steps of individual ontogenesis, namely the first step of eldership when the aging rate may increase manifold.

Sign in / Sign up

Export Citation Format

Share Document