title: Relationship between insulin resistance and C-reactive protein in a patient population treated with second generation antipsychotic medications.
abstract: C-reactive protein (CRP) is an inflammatory marker associated with obesity, insulin resistance, and cardiovascular disease. A recent study found CRP levels to be higher in individuals treated with certain antipsychotic medications such as olanzapine; however, it is not clear whether this is associated directly with drug intake or indirectly with drug-associated weight gain and insulin resistance. The objective of this study was to explore the potential predictors of CRP including insulin resistance, components of the metabolic syndrome, psychiatric diagnosis, and antipsychotic medication in patients treated with antipsychotics. Sixty-four outpatients without diabetes being treated with a single second generation antipsychotic medication had direct measurements of insulin resistance at the end of a 180-min infusion of glucose, insulin, and octreotide (insulin suppression test) as well as components of the metabolic syndrome. Insulin resistance was the strongest predictor of CRP (r=0.52, P<0.001). When adjusted for insulin resistance, there was no significant relationship between CRP and any of the components of the metabolic syndrome criteria, specific drug treatment or psychiatric diagnoses. In conclusion, insulin resistance is strongly associated with CRP levels and likely contributes to earlier associations between CRP and certain antipsychotic treatments.
authors.affiliation: Departments of aMedicine bPsychiatry, Stanford University School of Medicine, Stanford cVeterans Affairs, Palo Alto Health Care System, Palo Alto, California, USA. sunhkim@stanford.edu
authors.forename: Sun H
authors.initials: SH
authors.lastname: Kim
authors.forename: Gerald
authors.initials: G
authors.lastname: Reaven
authors.forename: Steven
authors.initials: S
authors.lastname: Lindley
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced*; D012306:Risk; D012307:Risk Factors
chemical_list: D014150:Antipsychotic Agents; D015415:Biomarkers; D002097:C-Reactive Protein