Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
J Clin Psychopharmacol. 2012 Jun;32(3):390-3. doi: 10.1097/JCP.0b013e3182524393.
The underlying mechanism for second-generation antipsychotic (SGA)-related glucose-lipid metabolic dysfunction is not fully understood. Recent studies have suggested a possible impact of SGAs on endocrine regulation, especially on adipocytokines. We examined the effect of each SGA on various adipocytokines in normal fasting glucose (NFG) subjects.
The study population comprised 113 Japanese inpatients with schizophrenia who were treated with olanzapine, risperidone, or quetiapine, and 123 healthy control (CONT) volunteers. All of the subjects were diagnosed with NFG. Plasma concentration of adiponectin, leptin, tumor necrosis factor α, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were compared between the SGA and CONT groups.
Second-generation antipsychotic subjects had significantly higher leptin levels in comparison to the CONT subjects. The plasma concentration of adiponectin, total cholesterol, and high-density lipoprotein cholesterol in the SGA subjects were significantly lower than those in the CONT subjects. There were no significant differences in tumor necrosis factor α, triglyceride, and low-density lipoprotein cholesterol levels between the 2 groups. In a stepwise multiple regression analysis, olanzapine was found to be a factor that contributed to decreased adiponectin levels, and the CONT subjects were detected to be a factor associated with lower leptin levels.
The present study indicates the possibility that the administration of SGAs may affect adipocytokines in the NFG stage, excluding the impaired fasting glucose group, which is in the transition stage into diabetes mellitus.
第二代抗精神病药物（SGA）相关糖脂代谢功能障碍的潜在机制尚未完全阐明。最近的研究表明，SGA 可能对内分泌调节产生影响，尤其是对脂肪细胞因子。我们研究了每种 SGA 对正常空腹血糖（NFG）受试者各种脂肪细胞因子的影响。
研究对象包括 113 名日本住院精神分裂症患者，分别接受奥氮平、利培酮或喹硫平治疗，以及 123 名健康对照（CONT）志愿者。所有受试者均被诊断为 NFG。比较 SGA 和 CONT 组之间的血浆脂联素、瘦素、肿瘤坏死因子 α、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇浓度。
与 CONT 组相比，第二代抗精神病药物组的瘦素水平显著升高。SGA 组的脂联素、总胆固醇和高密度脂蛋白胆固醇水平显著低于 CONT 组。两组之间肿瘤坏死因子 α、甘油三酯和低密度脂蛋白胆固醇水平无显著差异。逐步多元回归分析发现，奥氮平是导致脂联素水平降低的一个因素，而 CONT 组是导致瘦素水平降低的一个因素。
本研究表明，在排除了从糖尿病前期过渡到糖尿病的空腹血糖受损组后，SGA 的给药可能会影响 NFG 阶段的脂肪细胞因子。
