Department of Medicine and Surgery, Clinic of Child and Adolescent Neuropsychiatry, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Via S. Allende, Baronissi, 84081, Salerno, SA, Italy.
Faculty of Educational Science, Suor Orsola Benicasa University, Naples, Italy.
Clin Drug Investig. 2018 May;38(5):457-462. doi: 10.1007/s40261-018-0627-3.
Youth exposed to antipsychotics may experience several metabolic consequences that often limit the effectiveness of this class of drugs.
The aim of this study was to compare several metabolic markers between subjects who experienced antipsychotic-induced weight gain and untreated obese patients.
Nineteen non-diabetic youth (mean age 159 months, mean body mass index z-score 1.81) experiencing antipsychotic-induced weight gain and an age-, sex-, and body mass index-matched group of non-diabetic obese patients with no record of treatment (n = 19, mean age 147 months, mean body mass index z-score 2) were compared for a wide range of metabolic factors using a Bioplex Multiplex system.
C-peptide, glucose-dependent insulinotropic polypeptide, and adipsin were significantly higher in the antipsychotic-induced weight gain group, whereas visfatin was significantly higher in the untreated obese patients. When age, sex, pubertal status, and body mass index were controlled, C-peptide, glucose-dependent insulinotropic polypeptide, and visfatin remained significant, whereas adipsin fell slightly below the threshold of statistical significance. No other statistically significant difference emerged.
Antipsychotic-induced weight gain and untreated obesity showed some similarities, confirming that levels of some hormones, such as leptin and ghrelin, are related to body mass index rather than to antipsychotic exposure. Some differences were also noted; for example, the antipsychotic-induced weight gain group displayed higher C-peptide, glucose-dependent insulinotropic polypeptide, and adipsin, which may reflect β-cell stress and may suggest susceptibility to insulin resistance and lower visfatin, possibly indicating a lower inflammatory status.
接受抗精神病药物治疗的青少年可能会经历多种代谢后果，这通常会限制此类药物的疗效。
本研究旨在比较经历抗精神病药引起的体重增加的患者和未经治疗的肥胖患者之间的几种代谢标志物。
19 名非糖尿病青少年（平均年龄 159 个月，平均体重指数 z 评分 1.81）经历了抗精神病药引起的体重增加，以及一组年龄、性别和体重指数匹配的非糖尿病肥胖患者（无治疗记录）（n = 19，平均年龄 147 个月，平均体重指数 z 评分 2）使用 Bioplex Multiplex 系统比较了广泛的代谢因素。
在抗精神病药引起的体重增加组中，C 肽、葡萄糖依赖性胰岛素释放肽和脂联素显著升高，而未治疗的肥胖患者中内脂素显著升高。当控制年龄、性别、青春期状态和体重指数时，C 肽、葡萄糖依赖性胰岛素释放肽和内脂素仍然显著，而脂联素略低于统计学意义的阈值。没有出现其他具有统计学意义的差异。
抗精神病药引起的体重增加和未经治疗的肥胖症存在一些相似之处，这证实了一些激素（如瘦素和胃饥饿素）的水平与体重指数有关，而与抗精神病药暴露无关。还注意到了一些差异；例如，抗精神病药引起的体重增加组显示出更高的 C 肽、葡萄糖依赖性胰岛素释放肽和脂联素，这可能反映了β细胞的应激，可能提示易患胰岛素抵抗和内脂素降低，可能表明炎症状态较低。
