title: Adiposity and Cardiometabolic Risk in Children With and Without Antipsychotic Drug Treatment.
abstract: BACKGROUND
  Pediatric obesity is common, particularly in children treated with antipsychotic medications. Antipsychotic exposure can increase cardiometabolic risk by increasing adiposity, and possibly via other adiposity-independent pathways.
  
  
  OBJECTIVE
  The objectives were to characterize relationships of adiposity with intrahepatic triglyceride (IHTG) content and carotid intima media thickness (CIMT) in children with and without antipsychotic drug treatment, and to explore whether vitamin D alters any effects in these relationships.
  
  
  METHODS
  This was a cross-sectional case-control study.
  
  
  METHODS
  The setting was an academic medical center.
  
  
  METHODS
  Participants were 44 children (ages, 6-19 y): 25 cases treated with antipsychotic and other psychotropic drug therapies and 19 untreated controls, frequency-matched on age, gender, and body mass index.
  
  
  METHODS
  Main outcome measures were dual-energy x-ray absorptiometry percentage body fat (DEXA %fat), IHTG measured by magnetic resonance spectroscopy, and CIMT measured by ultrasonography. Fasting blood glucose, insulin, lipids, C-reactive protein, and liver enzymes were also evaluated.
  
  
  RESULTS
  There were no significant differences between cases and controls on measures of IHTG, CIMT, or DEXA %fat. In combined crude and adjusted analyses, DEXA %fat predicted IHTG (R(2) = 0.30) but not CIMT. Low levels of vitamin D were associated with larger effects of DEXA %fat on IHTG.
  
  
  CONCLUSIONS
  In treated and untreated children alike, adiposity is a significant predictor of liver fat content. This relationship was altered by low vitamin D level. These results suggest a modifiable pathway to hepatic steatosis. Further research is needed to test the hypothesis that children with high adiposity and low vitamin D have particularly increased risks for the development of fatty liver.
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Ginger E
authors.initials: GE
authors.lastname: Nicol
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Lisa
authors.initials: L
authors.lastname: de las Fuentes
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Riek
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Carlos
authors.initials: C
authors.lastname: Bernal-Mizrachi
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: J Phillip
authors.initials: JP
authors.lastname: Miller
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Schweiger
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Yingling
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Huang
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: David J
authors.initials: DJ
authors.lastname: Dixon
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Hennekens
authors.affiliation: Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431.
authors.forename: John W
authors.initials: JW
authors.lastname: Newcomer
mesh_terms: D050154:Adiposity / Q000187:drug effects*; D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D012306:Risk; D014807:Vitamin D / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D014807:Vitamin D