Cardiometabolic risk in first-episode schizophrenia (FES) patients with the earliest stages of both illness and antipsychotic treatment.
It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients.



We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naïve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs.



Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5% v.s. 14.9%, 9.2% v.s. 18.4%, 8.1% v.s. 14.9%, 8.6% v.s.18.3%, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9% v.s. 6.4%). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy.



These results indicated an early-onset nature of HDL-C abnormalities in drug-naïve FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.
The Second Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China; School of Public Health, Xinxiang Medical University, Xinxiang 453003, China.
Desheng
D
Zhai
School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China.
Taizhen
T
Cui
The Second Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China.
Yahui
Y
Xu
School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China.
Yihang
Y
Feng
McLean Hospital & Harvard Medical School, 115 Mill St., Belmont, MA 02478, USA.
Xin
X
Wang
The First Affiliated Hospital, Xinxiang Medical University, Weihui 453100, China.
Yuxin
Y
Yang
School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China.
Songji
S
Li
School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China.
Dushuang
D
Zhou
School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China.
Gaopan
G
Dong
School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China. Electronic address: zhaoyingxxmc@163.com.
Ying
Y
Zhao
Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, NY 13210, USA. Electronic address: yangyun@upstate.edu.
Yunlei
Y
Yang
The Second Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China. Electronic address: zhangruilingxx@163.com.
Ruiling
R
Zhang
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000139:chemically induced; D005260:Female; D006801:Humans; D052439:Lipid Metabolism Disorders / Q000097:blood* / Q000139:chemically induced; D008297:Male; D012189:Retrospective Studies; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy; D055815:Young Adult
D014150:Antipsychotic Agents
Antipsychotic treatment; Cardiometabolic risk; Earliest stages; First-episode schizophrenia