Lipid profile disturbances in antipsychotic-naive patients with first-episode non-affective psychosis: A systematic review and meta-analysis.
Dyslipidaemia is one of the most prevalent metabolic disturbances observed in schizophrenia patients and has been largely attributed to the effects of poor lifestyle habits and adverse effects of antipsychotic treatment. However, less is known whether patients with first-episode non-affective psychosis (FENP) present subthreshold indices of dyslipidaemia. Therefore, we tested the hypothesis whether subclinical lipid profile alterations occur already in antipsychotic-naïve FENP patients.



In this systematic review and meta-analysis we adhered to the PRISMA guidelines and searched PubMed, CINAHL Complete, Academic Search Complete, ERIC and Health Source: Nursing/Academic Edition from database inception to Dec 12, 2016, for case-control studies measuring the levels of total cholesterol, low- and high-density lipoproteins (LDL and HDL) and triglycerides in patients with FENP and controls. W calculated effect size (ES) estimates as Hedges' g and pooled data using random- or fixed-effects models depending on heterogeneity. Our study was registered in the PROSPERO database (CRD42016051732).



Out of 2466 records identified, 19 studies representing 1803 participants were finally included in our systematic review and meta-analysis. Pooled analysis revealed that FENP patients had significantly lower levels of total cholesterol [ES=-0.16 (95% CI: -0.27, -0.06), p=0.003], LDL [ES=-0.13 (95% CI: -0.24, -0.01), p=0.034] and HDL [ES=-0.27 (95% CI: -0.49, -0.05), p=0.018] as well as significantly higher levels of triglycerides [ES=0.22 (95% CI: 0.11, 0.32), p<0.001] compared to controls. After removing single studies in sensitivity analysis, ES estimate for LDL levels was insignificant.



Antipsychotic-naïve patients with FENP present subclinical dyslipidaemia. Future studies should disentangle whether our findings reflect disease-specific mechanisms.
Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368 Wroclaw, Poland. Electronic address: mblazej@interia.eu.
Błażej
B
Misiak
Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland.
Bartłomiej
B
Stańczykiewicz
Ludwik Hirszfeld Institute of Immunology and Experimental Therapy of the Polish Academy of Sciences, 12 Weigla Street, 11-400 Wroclaw, Poland.
Łukasz
Ł
Łaczmański
Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland.
Dorota
D
Frydecka
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood*; D011618:Psychotic Disorders / Q000097:blood*; D012559:Schizophrenia / Q000097:blood*
D015415:Biomarkers; D008055:Lipids
Cholesterol; Lipids; Lipoproteins; Metabolic dysregulation; Psychotic disorders; Schizophrenia