Glucose Metabolism, Thyroid Function, and Prolactin Level in Adolescent Patients With First Episode of Schizophrenia and Affective Disorders

Maria Giuseppina Petruzzelli; Lucia Marzulli; Orazio Valerio Giannico; Flora Furente; Mariella Margari; Emilia Matera; Francesco Margari

doi:10.3389/fpsyt.2020.00775

Glucose Metabolism, Thyroid Function, and Prolactin Level in Adolescent Patients With First Episode of Schizophrenia and Affective Disorders

Front Psychiatry. 2020 Aug 5:11:775. doi: 10.3389/fpsyt.2020.00775. eCollection 2020.

Authors

Maria Giuseppina Petruzzelli¹, Lucia Marzulli², Orazio Valerio Giannico², Flora Furente², Mariella Margari², Emilia Matera³, Francesco Margari¹

Affiliations

¹ Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
² Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
³ Child Neuropsychiatry Unit, Azienda Ospedaliero-Universitaria Policlinico di Bari, Bari, Italy.

Abstract

Schizophrenia and affective spectrum disorders (ASD) typically begin in adolescence or early adulthood. The pathophysiological mechanisms underlying these disorders are still not fully understood, and recent studies have suggested an involvement of dysfunctions in cardiometabolic and neuroendocrine systems at the onset of both disorders. In this context, we aimed to assess thyroid function, prolactin level, glucose metabolism, and lipid profile in drug naive adolescents, comparing patients with first episode of schizophrenia spectrum disorders (SSD) and patients with ASD. We performed a retrospective chart review from inpatients aged from ten to eighteen years, referred to Child and Adolescent Psychiatric Unit of University of Bari "Aldo Moro" over a period of 4 years, with diagnosis of SSD (n=30) or ASD (n=22), according to Diagnostic and Statistical Manual for Mental Disorders-fifth edition (DSM-5) criteria. Data on serum prolactin, glucose, insulin, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides, thyroid stimulating hormone, free triiodothyronin, and free thyroxin were collected, and the insulin resistance (IR) indexes "HOMA1-IR" and "HOMA2-IR" were calculated. The multivariable linear regression models, adjusting for potential confounding factors (age, sex, and BMI), showed HOMA1-IR (p=0.001), HOMA2-IR (p=0.002), glucose (p=0.004), insulin (p=0.004) and free thyroxin (p<0.001) values higher in the SSD group than in ASD. No others significant differences were found. Our findings suggest the need for a metabolic and endocrine screening at the onset of SSD and ASD, particularly for indexes of IR, that is a testable and treatable risk factor for cardiometabolic diseases. Further studies are required to better understand the role of endocrinological and metabolic dysfunctions at the onset of severe mental illness also considering influencing factors as age, gender, and BMI.

Keywords: early onset psychopathology; first episode of psychosis (FEP); insulin resistance; metabolic syndrome risk factors; mood disorders; neuroendocrine dysregulation.