title: Cardiovascular risk factors during second generation antipsychotic treatment are associated with increased C-reactive protein.
abstract: OBJECTIVE
  Severe mental disorder and cardiovascular disease (CVD) are often associated, and inflammation is implicated in both disorders. We investigated whether there is a relationship between CVD risk factors and inflammation in schizophrenia or bipolar disorder, and if second generation antipsychotics (SGA) interact.
  
  
  METHODS
  We included 361 patients in a naturalistic cross-sectional study, 235 subjects on current SGA treatment and 126 subjects not treated with SGA as controls. Cardiovascular parameters were measured and current medication recorded. Fasting plasma levels of the following cytokines were measured: high sensitivity CRP (hsCRP), soluble tumor necrosis factor receptor 1 (sTNF-R1), osteoprotegerin (OPG), soluble CD40 ligand (sCD40L), interleukin-1 receptor antagonist (IL-1Ra), von Willebrand factor (vWf) and interleukin-6 (IL-6).
  
  
  RESULTS
  In this relatively young sample of patients with a mean age of 33.3years, the following CVD risk factors were associated with elevated inflammation markers after adjusting for confounders: BMI, triglycerides and glucose with hsCRP (p=0.041-0.001), HDL-cholesterol and triglycerides with sTNF-R1 (p=0.009-0.001) and triglycerides with vWf (p=0.004). In patients treated with SGA, elevated hsCRP was significantly associated with high BMI (p=0.012), and with high glucose levels (p=0.003).
  
  
  CONCLUSIONS
  Several CVD risk factors are associated with elevated levels of inflammation markers in young patients with severe mental illness. The interaction between SGA and CVD risk factors on hsCRP levels might indicate a specific inflammatory activation related to SGA induced overweight and hyperglycemia. This suggests that hsCRP could be a valuable marker for future cardiovascular events, particularly in patients treated with SGA.
authors: Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. ingrid.dieset@medisin.uio.no
authors: Ingrid
authors: I
authors: Dieset
authors: Sigrun
authors: S
authors: Hope
authors: Thor
authors: T
authors: Ueland
authors: Thomas
authors: T
authors: Bjella
authors: Ingrid
authors: I
authors: Agartz
authors: Ingrid
authors: I
authors: Melle
authors: Pål
authors: P
authors: Aukrust
authors: Jan-Ivar
authors: JI
authors: Røssberg
authors: Ole A
authors: OA
authors: Andreassen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy; D001786:Blood Glucose / Q000187:drug effects; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000378:metabolism; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy; D014280:Triglycerides / Q000097:blood; D055815:Young Adult; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D016207:Cytokines; D053244:Osteoprotegerin; D018124:Receptors, Tumor Necrosis Factor; D014280:Triglycerides; D014841:von Willebrand Factor; D002097:C-Reactive Protein