title: Development of an atherogenic metabolic risk factor profile associated with the use of atypical antipsychotics.
abstract: BACKGROUND
  It is important to assess cardiovascular risk factors to properly verify the potential consequences of atypical antipsychotic-related weight gain. The objective of the present study was to evaluate whether 2 atypical antipsychotics differ regarding their impact on the cardiovascular disease risk profile compared with a reference group.
  
  
  METHODS
  We conducted a cross-sectional, multicenter study to assess anthropometric indices of obesity and to obtain a comprehensive fasting metabolic risk profile. Either risperidone or olanzapine had to be prescribed as the first and only antipsychotic for a minimum of 6 months. Patients were compared with a reference group of nondiabetic men. Data were collected from August 1999 to August 2001.
  
  
  RESULTS
  Eighty-seven patients treated with olanzapine (N = 42) or risperidone (N = 45) were evaluated. Olanzapine-treated patients had significantly higher plasma triglyceride concentrations (2.01 +/-1.05 vs. 1.34 +/-0.65 mmol/L, p < or =.05), lower high-density lipoprotein (HDL)-cholesterol levels (0.92 +/-0.17 vs. 1.04 +/- 0.21 mmol/L, p < or =.05), higher cholesterol/HDL-cholesterol ratios (5.62 +/-1.70 vs. 4.50 +/- 1.44, p < or =.05), higher apolipoprotein B levels (1.07 +/- 0.35 vs. 0.92 +/- 0.27 g/L, p < or =.05), smaller low-density lipoprotein peak particle diameters (252.6 +/-4.1 vs. 255.2 +/-4.3 A, p <.01), and higher fasting insulin concentrations (103.9 +/- 67.6 vs. 87.5 +/- 56.1 pmol/L, p < or =.05) than risperidone-treated patients. Moreover, 33% of olanzapine-treated patients were carriers of 3 atherogenic features of the metabolic syndrome as opposed to a prevalence of only 11% of risperidone-treated patients.
  
  
  CONCLUSIONS
  These results suggest that olanzapine-treated patients are characterized by a more deteriorated metabolic risk factor profile compared with risperidone-treated patients. These observations raise concerns about the potential differential long-term deleterious effects of some antipsychotics, such as olanzapine, on cardiovascular health.
authors.affiliation: Laval Hospital Research Center, Department of Food Sciences and Nutrition, Laval University, Pavilion Marguerite-D'Youville, 4th floor, 2725 chemin Ste-Foy, Ste-Foy, Québec, Canada G1V 4G5. Natalie.Almeras@crhl.ulaval.ca
authors.forename: Natalie
authors.initials: N
authors.lastname: Alméras
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
authors.forename: Julie
authors.initials: J
authors.lastname: Villeneuve
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Demers
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Roy
authors.forename: Camille
authors.initials: C
authors.lastname: Cadrin
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Mottard
authors.forename: Roch-Hugo
authors.initials: RH
authors.lastname: Bouchard
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D002353:Carrier State; D008076:Cholesterol, HDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000139:chemically induced / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005215:Fasting / Q000097:blood / Q000378:metabolism; D006306:Health Surveys; D006801:Humans; D015228:Hypertriglyceridemia / Q000235:genetics / Q000378:metabolism; D007328:Insulin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced / Q000378:metabolism*; D009765:Obesity / Q000097:blood / Q000139:chemically induced / Q000378:metabolism; D000077152:Olanzapine; D015995:Prevalence; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D012307:Risk Factors; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D015415:Biomarkers; D008076:Cholesterol, HDL; D007328:Insulin; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine