TY - JOUR
T1 - Adiposity and insulin sensitivity derived from intravenous glucose tolerance tests in antipsychotic-treated patients
AU - Haupt, Dan W.
AU - Fahnestock, Peter A.
AU - Flavin, Karen A.
AU - Schweiger, Julie A.
AU - Stevens, Angela
AU - Hessler, Martha J.
AU - Maeda, Justin
AU - Yingling, Michael
AU - Newcomer, John W.
N1 - Funding Information:
Supported by MH63985 (JN), MH 67795 (DH), NARSAD (JN and DH), Pfizer Inc., Janssen Pharmaceutica, USPHS 5MO1 RR00036, and Washington University Clinical Nutrition Research Unit Center Grant nos. P30 DK56341 and P60-DK20579.
PY - 2007/12
Y1 - 2007/12
N2 - Cardiovascular disease is more common in schizophrenia patients than in the general population, with a hypothesized contribution from increases in adiposity produced by antipsychotic medications. We sought to test the relationship between adiposity and insulin resistance using frequently sampled intravenous glucose tolerance tests (FSIVGTTs) to quantify whole-body insulin sensitivity in chronically treated patients with schizophrenia or schizoaffective disorder and untreated healthy controls. FSIVGTTs, body mass index (BMI), and waist circumference were obtained in nondiabetic patients (n=63) receiving olanzapine, risperidone, ziprasidone, or first generation antipsychotics, as well as in healthy controls (n=14). Subject groups (including untreated healthy controls) were matched for BMI and all treated patient groups were additionally matched for age. Bergman's minimal model (MinMod) was used to calculate insulin sensitivity (SI), as well as secondary measures of interest. BMI and waist circumference significantly predicted insulin sensitivity measured as MinMod SI (F(1,62)=35.11, p<0.0001 and F(1,46)=24.48, p<0.0001, respectively). In addition, BMI and waist circumference significantly predicted the acute plasma insulin response to the glucose challenge (AIRG), consistent with a β cell compensatory response to insulin resistance (MinMod AIRG F(1,65)=22.42, p<0.0001 and F(1,49)=11.72, p=0.0013, respectively). Adiposity levels occurring during antipsychotic treatment are strongly related to insulin resistance, confirming that antipsychotic-induced weight gain can contribute to increased cardiometabolic risk in this population.
AB - Cardiovascular disease is more common in schizophrenia patients than in the general population, with a hypothesized contribution from increases in adiposity produced by antipsychotic medications. We sought to test the relationship between adiposity and insulin resistance using frequently sampled intravenous glucose tolerance tests (FSIVGTTs) to quantify whole-body insulin sensitivity in chronically treated patients with schizophrenia or schizoaffective disorder and untreated healthy controls. FSIVGTTs, body mass index (BMI), and waist circumference were obtained in nondiabetic patients (n=63) receiving olanzapine, risperidone, ziprasidone, or first generation antipsychotics, as well as in healthy controls (n=14). Subject groups (including untreated healthy controls) were matched for BMI and all treated patient groups were additionally matched for age. Bergman's minimal model (MinMod) was used to calculate insulin sensitivity (SI), as well as secondary measures of interest. BMI and waist circumference significantly predicted insulin sensitivity measured as MinMod SI (F(1,62)=35.11, p<0.0001 and F(1,46)=24.48, p<0.0001, respectively). In addition, BMI and waist circumference significantly predicted the acute plasma insulin response to the glucose challenge (AIRG), consistent with a β cell compensatory response to insulin resistance (MinMod AIRG F(1,65)=22.42, p<0.0001 and F(1,49)=11.72, p=0.0013, respectively). Adiposity levels occurring during antipsychotic treatment are strongly related to insulin resistance, confirming that antipsychotic-induced weight gain can contribute to increased cardiometabolic risk in this population.
KW - Antipsychotics
KW - Cardiovascular risk
KW - Diabetes
KW - Insulin resistance
KW - Obesity
KW - Schizophrenia
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U2 - 10.1038/sj.npp.1301392
DO - 10.1038/sj.npp.1301392
M3 - Article
C2 - 17375138
AN - SCOPUS:36248987288
SN - 0893-133X
VL - 32
SP - 2561
EP - 2569
JO - Neuropsychopharmacology
JF - Neuropsychopharmacology
IS - 12
ER -