Body composition, pre-diabetes and cardiovascular disease risk in early schizophrenia

Martin Strassnig, Jennifer L Clarke, Steve Mann, Gary Remington, Rohan Ganguli

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Aim: This preliminary study examines the relationship between body composition, insulin resistance and NCEP-III-defined cardiovascular disease risk factors in persons early in the course of schizophrenia exposed to commonly prescribed atypical antipsychotic medications. Methods: Subjects underwent modified oral glucose tolerance tests (OGTTs) and DEXA (dual X-ray absorptiometry) scans corrected for relevant sociodemographic data, including activity levels. We used linear multiple regression models to evaluate relationships between body composition and metabolic variables. Results: Thirty-six individuals diagnosed with schizophrenia, receiving atypical antipsychotic monotherapy, and within 5 years of illness onset, participated. Average age was 25.1 ± 3.6 years (range, 19–34) and duration of illness was 2.5 years (30 ± 18 months). Mean body mass index (BMI) was 28.3 ± 4.9, with a mean total body fat mass of 28.6 ± 8.4%, suggesting an increase in fat relative to BMI. Ten participants (28%) had pre-diabetes (fasting glucose 100–126 mg dL −1 or 2-h OGTT 140–200 mg dL −1 ), but no participant had diabetes. Insulin resistance (HOMA-IR) was predicted by total body mass (BMI) more so than by body fat mass, with an incremental contribution derived from antipsychotics. Insulin secretion in response to glucose challenge was predicted by BMI, body fat mass and antipsychotic medication. Conclusions: Fat mass relative to BMI was increased in early schizophrenia patients receiving atypical antipsychotics. Body composition accounted for most of the variance in risk for abnormalities in glucose metabolism. Incremental contributions were derived from atypical antipsychotics, in line with their known adipogenicity. If direct fat mass measures are unavailable, frequent BMI measures may be practical proxy markers for metabolic risk.

Original languageEnglish (US)
Pages (from-to)229-236
Number of pages8
JournalEarly Intervention in Psychiatry
Volume11
Issue number3
DOIs
StatePublished - Jun 1 2017

Fingerprint

Body Composition
Antipsychotic Agents
Schizophrenia
Body Mass Index
Cardiovascular Diseases
Adipose Tissue
Fats
Glucose Tolerance Test
Glucose
Insulin Resistance
Photon Absorptiometry
Proxy
Linear Models
Fasting
Insulin

Keywords

  • body composition
  • cardiovascular disease
  • diabetes
  • obesity
  • schizophrenia

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Body composition, pre-diabetes and cardiovascular disease risk in early schizophrenia. / Strassnig, Martin; Clarke, Jennifer L; Mann, Steve; Remington, Gary; Ganguli, Rohan.

In: Early Intervention in Psychiatry, Vol. 11, No. 3, 01.06.2017, p. 229-236.

Research output: Contribution to journalArticle

Strassnig, Martin ; Clarke, Jennifer L ; Mann, Steve ; Remington, Gary ; Ganguli, Rohan. / Body composition, pre-diabetes and cardiovascular disease risk in early schizophrenia. In: Early Intervention in Psychiatry. 2017 ; Vol. 11, No. 3. pp. 229-236.
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