Association of adiponectin and metabolic syndrome among patients taking atypical antipsychotics for schizophrenia: a cohort study.
BACKGROUND
Adiponectin, an adipocyte-derived hormone controlling lipid and carbohydrate metabolism, has been suggested to be a biomarker for metabolic syndrome in the general population. This study investigated the association between adiponectin levels and metabolic syndrome in patients treated with atypical antipsychotics.


METHODS
Anthropometric and metabolic parameters and serum adiponectin levels were assessed in hospitalized patients with schizophrenia who had used the same atypical antipsychotic for at least 3 months. Retrospective reviews of the patients' medical records were conducted to obtain demographic data and pretreatment characteristics.


RESULTS
The study included 567 schizophrenia patients treated with clozapine (n=231), olanzapine (n=94) and risperidone (n=242), for an average of 45.8+/-27.8 months. The prevalence of metabolic syndrome among all subjects was 23.8%. The clozapine group had a higher prevalence of metabolic syndrome (28.7%) than did the olanzapine (24.2%) and risperidone groups (19.5%) (P=0.039), and the clozapine group had lower levels of adiponectin (8.46+/-6.02 mg/mL) than did the olanzapine (10.26+/-4. 9 mg/mL) and risperidone groups (10.69+/-7.43 mg/mL) (P=0.001). Adiponectin level was negatively correlated with body mass index (BMI) increase after initiation of antipsychotic treatment. Cross-sectional regression analysis showed that age (OR,=1.042, P=0.001), BMI (OR=1.404, P<0.0001), and adiponectin level (OR=0.862, P<0.0001) were significant factors in the presence of metabolic syndrome. Significant predictors of metabolic syndrome were age at initiation of antipsychotic treatment (OR=1.04, P=.007), BMI at initiation of antipsychotic treatment (OR=1.44, P<0.0001), BMI increase after initiation of antipsychotic treatment (OR=1.40, P<0.0001), and adiponectin level (OR=0.86, P<0.0001).


CONCLUSIONS
Lower levels of adiponectin and weight gain after taking antipsychotics are associated with higher risk of metabolic syndrome in patients taking atypical antipsychotics.
Bai
Ya Mei
YM
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Chen
Tzu Ting
TT
Yang
Wei-Shiung
WS
Chi
Yu-Chao
YC
Lin
Chao-Cheng
CC
Liou
Ying-Jay
YJ
Wang
Ying-Chieh
YC
Su
Tung-Ping
TP
Chou
Pesus
P
Chen
Jen-Yeu
JY
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008659:Metabolic Diseases / Q000097:blood* / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D013624:Taiwan
D052242:Adiponectin; D014150:Antipsychotic Agents