Risk of Nonalcoholic Fatty Liver Disease in Patients With Schizophrenia Treated With Antipsychotic Drugs: A Cross-sectional Study

J Clin Psychopharmacol. 2021 Jul-Aug;41(4):474-477. doi: 10.1097/JCP.0000000000001421.

Abstract

Background: Although the prevalence of metabolic syndrome in patients with schizophrenia is higher than the prevalence in the general population, little is known regarding nonalcoholic fatty liver disease (NAFLD) in patients with schizophrenia.

Procedures: We analyzed the medical records of patients with schizophrenia/schizoaffective disorder (N = 253) who received an abdominal echography.

Results: In total, 108 patients (42.7%) showed NAFLD on abdominal echography. Of these, 13 patients (12.0%) showed signs of fibrosis on abdominal echography. In terms of age distribution, NAFLD was more prevalent in younger patients, particularly in female patients. We also found that body mass index, the total dose of antipsychotic drugs that carry a risk of metabolic syndrome, and the total dose of antipsychotic drugs that carry a risk of hyperprolactinemia were significantly associated with NAFLD (P < 0.001, 0.049, and 0.041, respectively). In our exploratory analysis, we found that signs of fibrosis in NAFLD were more highly associated with female patients (P = 0.023). Importantly, the risk in younger female patients may be specific to patients with schizophrenia compared with the general population.

Conclusions: Considering that antipsychotic drugs were associated with the development of NAFLD, early detection and management of NAFLD should be conducted in patients with schizophrenia.

MeSH terms

  • Adult
  • Antipsychotic Agents* / administration & dosage
  • Antipsychotic Agents* / adverse effects
  • Dose-Response Relationship, Drug
  • Early Diagnosis
  • Female
  • Humans
  • Japan / epidemiology
  • Liver Cirrhosis / diagnostic imaging*
  • Male
  • Medical Records / statistics & numerical data
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease* / diagnosis
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Non-alcoholic Fatty Liver Disease* / prevention & control
  • Prevalence
  • Risk Assessment / methods
  • Risk Factors
  • Schizophrenia / drug therapy*
  • Schizophrenia / epidemiology
  • Sex Factors
  • Ultrasonography / methods
  • Ultrasonography / statistics & numerical data

Substances

  • Antipsychotic Agents