Cytokine and adipokine alterations in patients with schizophrenia treated with clozapine.
Metabolic syndrome is associated with both schizophrenia and antipsychotic medication, especially clozapine, with alterations in inflammatory cytokines and adipokines. However, the data in this field is heterogeneous and the sample sizes of the patients are limited. In this study we assessed the serum levels of cytokines/adipokines IL-6, IL-1Ra, hs-CRP and adiponectin, and components of metabolic syndrome in 190 patients with treatment resistant schizophrenia treated with clozapine. Substantial metabolic comorbidity was found in this patient group; overweight/obesity, smoking, hypertriglyceridemia, low HDL-cholesterol, high HOMA-IR, low adiponectin levels, elevated hs-CRP levels and elevated IL-1Ra levels. Elevated IL-1Ra levels are associated with insulin resistance, obesity and hypertriglyceridemia. Low adiponectin levels were associated with hypertriglyceridemia, low HDL cholesterol and high glucose, and in male patients also with obesity and high IL-1Ra levels. After controlling for confounding factors age and smoking, levels of IL-1Ra and hs-CRP associated with obesity, and the levels of IL-6 associated with obesity in female patients. We conclude that there are partly gender dependent cytokine and adipokine alterations in patients with schizophrenia on clozapine treatment associated with metabolic comorbidity. The genetic background of these cytokine alterations needs to be further investigated.
Tampere University Hospital, Department of Psychiatry, Pitkäniemi Hospital, 33380 Pitkäniemi, Finland. Electronic address: jari-pekka.klemettila@pshp.fi.
Jari-Pekka
JP
Klemettilä
University of Tampere, School of Medicine, 33014 Tampere, Finland; Seinäjoki Hospital District, Department of Psychiatry, 60220 Seinäjoki, Finland.
Olli
O
Kampman
Satakunta Hospital District, Department of Psychiatry, 28500 Pori, Finland.
Niko
N
Seppälä
University of Tampere, School of Medicine, 33014 Tampere, Finland; Tampere Mental Health Centre, Hallituskatu 8B, 33200 Tampere, Finland.
Merja
M
Viikki
Immunopharmacology Research Group, University of Tampere, School of Medicine, 33014 Tampere, Finland; Tampere University Hospital, 33520 Tampere, Finland.
Mari
M
Hämäläinen
Immunopharmacology Research Group, University of Tampere, School of Medicine, 33014 Tampere, Finland; Tampere University Hospital, 33520 Tampere, Finland.
Eeva
E
Moilanen
Tampere University Hospital, Department of Psychiatry, Pitkäniemi Hospital, 33380 Pitkäniemi, Finland; University of Tampere, School of Medicine, 33014 Tampere, Finland.
Esa
E
Leinonen
D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001685:Biological Factors / Q000097:blood; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D016207:Cytokines / Q000097:blood* / Q000187:drug effects; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D012559:Schizophrenia / Q000097:blood* / Q000150:complications / Q000188:drug therapy*
D054392:Adipokines; D052242:Adiponectin; D014150:Antipsychotic Agents; D001685:Biological Factors; D016207:Cytokines; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6; D003024:Clozapine
Adiponectin; Hs-CRP; IL-1Ra; IL-6; Metabolic syndrome