title: Differential effects of olanzapine and clozapine on plasma levels of adipocytokines and total ghrelin.
abstract: Second-generation antipsychotics (SGAs) have been associated with an increased liability for weight gain and metabolic side effects. Among SGAs, clozapine and olanzapine had great liability to induce weight gain and metabolic adverse reactions. Leptin, adiponectin, and total ghrelin play important roles in energy homeostasis and are suggested to be biomarkers of metabolic disturbances. The purpose of the present study was to investigate the differential effects of antipsychotics (olanzapine and clozapine) on the levels of adipocytokines (leptin and adiponectin) and total ghrelin. Three hundred and thirty-three patients with schizophrenia under clozapine or olanzapine monotherapy were recruited. Control participants were recruited from a healthy community population based on a health investigation (N=119). Fasting blood samples for glucose, cholesterol, triglycerides, leptin, adiponectin, and total ghrelin were analyzed. There were significant differences in the levels of cholesterol, triglycerides, and glucose between these three groups. Post hoc comparisons showed that the olanzapine group had the highest levels of cholesterol and triglycerides. The levels of leptin, adiponectin, and total ghrelin were also significantly different between the three groups after controlling age and body mass index (BMI). Post hoc comparisons showed that the olanzapine group had the lowest levels of adiponectin and total ghrelin. The present study found that the uses of olanzapine and clozapine were associated with changes in adipocytokines and total ghrelin, even after adjusting potential confounding factors. Olanzapine had greater influences on adiponectin and total ghrelin than clozapine. The changes in adipocytokines and total ghrelin were a direct effect of antipsychotics on hormonal pathways of energy homeostasis, rather than the result of weight gain.
authors.affiliation: Department of Psychiatry, Wan-Fang Hospital and School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Mong-Liang
authors.initials: ML
authors.lastname: Lu
authors.affiliation: Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Tsu-Nai
authors.initials: TN
authors.lastname: Wang
authors.affiliation: Tsaotun Psychiatric Center Department of Health, Nan-Tou, Taiwan.
authors.forename: Tsang-Yaw
authors.initials: TY
authors.lastname: Lin
authors.affiliation: Tsaotun Psychiatric Center Department of Health, Nan-Tou, Taiwan.
authors.forename: Wen-Chuan
authors.initials: WC
authors.lastname: Shao
authors.affiliation: Tsaotun Psychiatric Center Department of Health, Nan-Tou, Taiwan.
authors.forename: Sheng-Huang
authors.initials: SH
authors.lastname: Chang
authors.affiliation: Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jen-Yu
authors.initials: JY
authors.lastname: Chou
authors.affiliation: Institute of Medicine, Chung Shan Medical University Taichung, Taiwan.
authors.forename: Yi-Feng
authors.initials: YF
authors.lastname: Ho
authors.affiliation: Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yin-To
authors.initials: YT
authors.lastname: Liao
authors.affiliation: Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan. Electronic address: hjcch@yahoo.com.tw.
authors.forename: Vincent Chin-Hung
authors.initials: VC
authors.lastname: Chen
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000375:Aging / Q000097:blood / Q000187:drug effects; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003024:Clozapine / Q000627:therapeutic use*; D005215:Fasting / Q000097:blood; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D014280:Triglycerides / Q000097:blood
chemical_list: D054392:Adipokines; D014150:Antipsychotic Agents; D001786:Blood Glucose; D054439:Ghrelin; D014280:Triglycerides; D001569:Benzodiazepines; D002784:Cholesterol; D003024:Clozapine; D000077152:Olanzapine
keywords: Adiponectin; Clozapine; Ghrelin; Leptin; Olanzapine; Schizophrenia