Hormonal markers of metabolic dysregulation in patients with severe mental disorders after olanzapine treatment under real-life conditions.
OBJECTIVE
Dyslipidemia independent of body mass has previously been reported in humans after antipsychotic treatment. The present study investigated the levels of several metabolic regulatory hormones in psychiatric outpatients treated with different antipsychotics under real-life conditions.


METHODS
The study included cross-sectional data from 234 subjects on stable monotherapy with any of the following: olanzapine (n = 72), any other antipsychotic (n = 80), or no medications (n = 82). Groups were well matched for sex, body mass index (BMI), ethnicity, and smoking. After adjustment for differences in age and illness duration, groups were compared for the insulin resistance index (homeostatic model assessment of insulin resistance) and fasting concentrations of glucose, lipids, insulin, sex hormone-binding globulin (SHBG), adiponectin, leptin, and cortisol. Correlations were examined between serum olanzapine and hormonal levels, and between leptin concentrations and BMI in both sexes.


RESULTS
Significant intergroup differences in concentrations of insulin (P = 0.025), SHBG (P = 0.001), adiponectin (P = 0.017), and cortisol (P = 0.003) but no significant difference for homeostatic model assessment of insulin resistance (P = 0.051) were found, independent of body mass. Olanzapine-treated subjects had the highest insulin concentrations and the lowest SHBG, adiponectin, and cortisol concentrations. Olanzapine-treated female subjects had significantly higher leptin (P = 0.005) and lower SHBG (P = 0.023) concentrations than other subjects. In female subjects, serum olanzapine concentrations were correlated with hormonal levels, and a significant proportion of olanzapine-treated female subjects had abnormal correlations between serum leptin levels and BMI.


CONCLUSIONS
Alterations in several interrelated metabolic hormonal markers were associated with olanzapine treatment, independent of body mass, particularly in female subjects.
Birkenaes
Astrid B
AB
Department of Psychiatry, Akershus University Hospital, Lørenskog, Norway. a.b.birkenas@medisin.uio.no
Birkeland
Kåre I
KI
Friis
Svein
S
Opjordsmoen
Stein
S
Andreassen
Ole A
OA
D052242:Adiponectin / Q000097:blood; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D015992:Body Mass Index; D018849:Controlled Clinical Trials as Topic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D000077152:Olanzapine; D012720:Severity of Illness Index; D012737:Sex Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D055815:Young Adult
D052242:Adiponectin; D014150:Antipsychotic Agents; D007328:Insulin; D020738:Leptin; D012738:Sex Hormone-Binding Globulin; D001569:Benzodiazepines; D000077152:Olanzapine; D006854:Hydrocortisone