title: Meta-analysis of glucose tolerance, insulin, and insulin resistance in antipsychotic-naïve patients with nonaffective psychosis.
abstract: Some studies have suggested that antipsychotic-naïve patients with nonaffective psychosis (NAP) have glucose intolerance.
  
  
  
  To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR).
  
  
  
  We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts. We required studies to include subjects with nonaffective psychosis and control subjects.
  
  
  
  There were 911 patients and 870 control subjects in the analysis of FG; their average ages were respectively 28.7 and 29.5years. Significant differences were found for all four variables, with effect size estimates ranging from 0.21 to 0.58.
  
  
  
  As a group, at the time of first clinical contact for psychosis, people with NAP have a slight increase in FG, which most of them maintain in the normal range despite a small increase in IR by secreting additional INS. When faced with a physiological challenge such as a glucose tolerance test or antipsychotics, they are no longer able to maintain a normal glucose concentration.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Nevada School of Medicine, Reno, NV, United States.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Greenhalgh
authors.affiliation: Department of Psychiatry, University of Oviedo, & Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: Gonzalez-Blanco
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.
authors.forename: Clemente
authors.initials: C
authors.lastname: Garcia-Rizo
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Huntingdon, UK.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fernandez-Egea
authors.affiliation: Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Miller
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.
authors.forename: Miguel Bernardo
authors.initials: MB
authors.lastname: Arroyo
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Nevada School of Medicine, Reno, NV, United States. Electronic address: bkirkpatrick2@aol.com.
authors.forename: Brian
authors.initials: B
authors.lastname: Kirkpatrick
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D011618:Psychotic Disorders / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Antipsychotic-naïve; Diabetes; Glucose tolerance; Insulin; Schizophrenia