High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine
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High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine. / Larsen, Julie R.; Svensson, Camilla K.; Vedtofte, Louise; Jakobsen, Mathilde Lund; Jespersen, Hans Søe; Jakobsen, Michelle I.; Koyuncu, Kamuran; Schjerning, Ole; Nielsen, Jimmi; Ekstrøm, Claus T.; Holst, Jens J.; Correll, Christoph U; Vilsbøll, Tina; Fink-Jensen, Anders.
I: CNS Spectrums, Bind 24, Nr. 4, 2019, s. 441-452.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine
AU - Larsen, Julie R.
AU - Svensson, Camilla K.
AU - Vedtofte, Louise
AU - Jakobsen, Mathilde Lund
AU - Jespersen, Hans Søe
AU - Jakobsen, Michelle I.
AU - Koyuncu, Kamuran
AU - Schjerning, Ole
AU - Nielsen, Jimmi
AU - Ekstrøm, Claus T.
AU - Holst, Jens J.
AU - Correll, Christoph U
AU - Vilsbøll, Tina
AU - Fink-Jensen, Anders
PY - 2019
Y1 - 2019
N2 - OBJECTIVE: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes.METHODS: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c.RESULTS: Among 145 schizophrenia patients (age=42.1 years; males=59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P=0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P=0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes.CONCLUSION: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.
AB - OBJECTIVE: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes.METHODS: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c.RESULTS: Among 145 schizophrenia patients (age=42.1 years; males=59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P=0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P=0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes.CONCLUSION: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.
U2 - 10.1017/S1092852918001311
DO - 10.1017/S1092852918001311
M3 - Journal article
C2 - 30596361
VL - 24
SP - 441
EP - 452
JO - CNS Spectrums
JF - CNS Spectrums
SN - 1092-8529
IS - 4
ER -
ID: 214749376