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High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine

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Larsen, Julie R ; Svensson, Camilla K ; Vedtofte, Louise ; Jakobsen, Mathilde Lund ; Jespersen, Hans Søe ; Jakobsen, Michelle I ; Koyuncu, Kamuran ; Schjerning, Ole ; Nielsen, Jimmi ; Ekstrøm, Claus T ; Holst, Jens J ; Correll, Christoph U ; Vilsbøll, Tina ; Fink-Jensen, Anders. / High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine. I: CNS Spectrums. 2019 ; Bind 24, Nr. 4. s. 441-452.

Bibtex

@article{4a9adfd8c7b64d6986b93507e5f1c7bc,
title = "High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine",
abstract = "Objective: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. Methods: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m 2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c. Results: Among 145 schizophrenia patients (age = 42.1 years; males = 59.3{\%}) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8{\%}/24.1{\%}/2.1{\%}), prediabetes was present in 69.7{\%} (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2{\%} vs 40.9{\%}, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes. Conclusion: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.",
keywords = "Antipsychotic, glucose metabolism, metabolic syndrome, prediabetes, schizophrenia",
author = "Larsen, {Julie R} and Svensson, {Camilla K} and Louise Vedtofte and Jakobsen, {Mathilde Lund} and Jespersen, {Hans S{\o}e} and Jakobsen, {Michelle I} and Kamuran Koyuncu and Ole Schjerning and Jimmi Nielsen and Ekstr{\o}m, {Claus T} and Holst, {Jens J} and Correll, {Christoph U} and Tina Vilsb{\o}ll and Anders Fink-Jensen",
year = "2019",
month = "8",
day = "1",
doi = "10.1017/S1092852918001311",
language = "English",
volume = "24",
pages = "441--452",
journal = "CNS Spectrums",
issn = "1092-8529",
publisher = "M B L Communications",
number = "4",

}

RIS

TY - JOUR

T1 - High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine

AU - Larsen, Julie R

AU - Svensson, Camilla K

AU - Vedtofte, Louise

AU - Jakobsen, Mathilde Lund

AU - Jespersen, Hans Søe

AU - Jakobsen, Michelle I

AU - Koyuncu, Kamuran

AU - Schjerning, Ole

AU - Nielsen, Jimmi

AU - Ekstrøm, Claus T

AU - Holst, Jens J

AU - Correll, Christoph U

AU - Vilsbøll, Tina

AU - Fink-Jensen, Anders

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Objective: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. Methods: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m 2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c. Results: Among 145 schizophrenia patients (age = 42.1 years; males = 59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes. Conclusion: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.

AB - Objective: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. Methods: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m 2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c. Results: Among 145 schizophrenia patients (age = 42.1 years; males = 59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes. Conclusion: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.

KW - Antipsychotic

KW - glucose metabolism

KW - metabolic syndrome

KW - prediabetes

KW - schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=85069738710&partnerID=8YFLogxK

U2 - 10.1017/S1092852918001311

DO - 10.1017/S1092852918001311

M3 - Journal article

VL - 24

SP - 441

EP - 452

JO - CNS Spectrums

JF - CNS Spectrums

SN - 1092-8529

IS - 4

ER -

ID: 56439898