[Possible connection between ghrelin, resistin and TNF-alpha levels and the metabolic syndrome caused by atypical antipsychotics].
Second generation antipsychotics (SGA) are obesitogenic and diabetogenic. Role of ghrelin (RIA), resistin and TNF-alpha (ELISA) in weight gain and insulin resistance (fasting plasma insulin, HOMA, ELISA) was studied in Hungarian psychiatryic patients (n=60) treated with SGA (clozapine, olanzapine, risperidone, quetiapine, 15 each). After 1 year, 80% of patients became overweight/obese (BMI > 27/30) and 35% (n= 21/60) presented impaired glucose tolerance (13/60) or diabetes (8/60). Ghrelin (1.3 +/- 0.6 ng/ml), resistin (9.8 +/- 3.7 ng/ml), TNF-alpha (5.8 +/- 1.7 pg/ml), insulin (10.4 +/- 7.6 U/ml, HOMA A: 2.5 +/- 1.8, HOMA B: 133 +/- 62.5) were significantly higher in patients than in healthy matched controls. Resistin and TNF-alpha positively correlated with each other, insulin, HOMA, and negatively with ghrelin. Ghrelin contributes to weight gain, resistin and TNF-alpha to insulin resistance. A negative feedback regulation may exist between adipocytokines and ghrelin production. SGA drugs enhance ghrelin production despite the suppressive effect of adipocytokines. All four SGA drugs are equally obesitogenic and diabetogenic.
Birkás Kováts
Dezso
D
Psychiátriai Kilinikai Csoport, Kútvolgyi Klinikai Tömb, Semmelweis Egyetem, Budapest.
Palik
Eva
E
Faludi
Gábor
G
Cseh
Károly
K
D014150:Antipsychotic Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects; D050260:Carbohydrate Metabolism / Q000187:drug effects; D016022:Case-Control Studies; D003024:Clozapine / Q000009:adverse effects; D003987:Dibenzothiazepines / Q000009:adverse effects; D005260:Female; D054439:Ghrelin; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000139:chemically induced*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000139:chemically induced; D000077152:Olanzapine; D050177:Overweight / Q000187:drug effects; D036361:Peptide Hormones / Q000009:adverse effects* / Q000097:blood; D000069348:Quetiapine Fumarate; D052243:Resistin / Q000009:adverse effects* / Q000097:blood; D018967:Risperidone / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects* / Q000378:metabolism; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D054439:Ghrelin; D036361:Peptide Hormones; D052243:Resistin; D014409:Tumor Necrosis Factor-alpha; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine