title: Dysmetabolic features of the overweight patients receiving antipsychotic drugs: a comparison with normal weight and obese subjects.
abstract: BACKGROUND
  Extensive research indicates that obesity, defined by a body mass index (BMI) greater or equal to 30, is common in patients treated with antipsychotic drugs and is frequently associated with carbohydrate and lipid abnormalities leading to metabolic syndrome and diabetes. In contrast, the metabolic health of overweight patients (BMI=25-29.9) without metabolic syndrome or diabetes has not been thoroughly investigated.
  
  
  OBJECTIVE
  To assess the metabolic health of overweight patients receiving antipsychotic drugs.
  
  
  METHODS
  We compared standard metabolic parameters (BMI; waist circumference; hemoglobin A1c; fasting lipids; and fasting and post-challenge glucose and insulin) of normal weight, overweight and obese individuals from a consecutive cohort of antipsychotic-treated patients without metabolic syndrome and/or diabetes.
  
  
  RESULTS
  Compared with the normal weight subjects (n=286), overweight patients (n=212) had higher fasting insulin resistance as assessed with the homeostatic model (P=0.023), insulin secretion during the oral glucose tolerance test (P=0.0037), triglycerides (P=0.0004) and low-density lipoprotein cholesterol (P=0.0089), and lower levels of high-density lipoprotein cholesterol (P=0.0014). The obese (n=50) were different from the overweight subjects only with respect to higher post-challenge insulin levels (P=0.0002). The average fasting glucose, post-challenge glucose, and hemoglobin A1c, severity of psychiatric disorders and antipsychotics used were similar in the three groups.
  
  
  CONCLUSIONS
  Overweight (BMI=25-29.9) patients receiving antipsychotics are metabolically closer to the obese than to normal weight counterparts. The findings suggest that interventions promoting weight loss and metabolic health are required for overweight patients even in the absence of metabolic syndrome or diabetes.
authors: Medical Services, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Hofstra North Shore, LIJ School of Medicine, Hempstead, New York, USA; Transilvania University, Brasov, Romania. Electronic address: pmanu@nshs.edu.
authors: P
authors: P
authors: Manu
authors: Medical Services, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Hofstra North Shore, LIJ School of Medicine, Hempstead, New York, USA; Feinstein Institute for Medical Research, Manhasset, New York, USA.
authors: C-U
authors: CU
authors: Correll
authors: Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium.
authors: M
authors: M
authors: Wampers
authors: Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium; School of Mental Health and Neuroscience (EURON), University Medical Center, Maastricht, The Netherlands.
authors: R
authors: R
authors: van Winkel
authors: Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium.
authors: W
authors: W
authors: Yu
authors: Medical Services, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA.
authors: D
authors: D
authors: Shiffeldrim
authors: Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium.
authors: M
authors: M
authors: De Hert
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001835:Body Weight; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism; D050177:Overweight / Q000097:blood / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D007328:Insulin; D014280:Triglycerides
keywords: Antipsychotics; Epidemiology