Parameters of glucose and lipid metabolism at the fasted state in drug-naïve first-episode patients with psychosis: Evidence for insulin resistance

Psychiatry Res. 2015 Oct 30;229(3):901-4. doi: 10.1016/j.psychres.2015.07.041. Epub 2015 Aug 7.

Abstract

Diabetes and dyslipidemia are common in patients with psychosis; this association may be partly related to adverse metabolic effects of antipsychotic medications. We assessed glucose and lipid metabolism during the fasted state in drug-naïve patients with psychosis. Fasting serum concentrations of total cholesterol, triglycerides, high density lipoprotein (HDL), glucose, insulin, connecting peptide (C-peptide), homeostatic model assessment index (HOMA-IR), glycated hemoglobin (HbA1C) and serum cortisol were compared between a group of 40 newly diagnosed drug-naïve, first-episode patients with psychosis and a group of 40 healthy controls, matched for age, sex and BMI. Total cholesterol, triglycerides and fasting glucose levels were similar, whereas insulin and C-peptide levels were higher and HDL marginally lower in the patients' group compared to those in healthy controls. Drug-naïve patients with psychosis were more insulin resistant (as assessed by the HOMA-R index) compared to healthy controls. Serum cortisol did not differ between the two groups. There is evidence that drug-naïve, first-episode patients with psychosis are more insulin resistant compared to healthy controls.

Keywords: Cholesterol; Diabetes; Dyslipidemia; First-episode; Metabolism; Schizophrenia.

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Blood Glucose / metabolism*
  • Body Mass Index
  • C-Peptide / blood
  • Case-Control Studies
  • Cholesterol / blood
  • Fasting / blood*
  • Female
  • Glycated Hemoglobin / analysis
  • Homeostasis
  • Humans
  • Hydrocortisone / blood
  • Insulin / blood
  • Insulin Resistance / physiology*
  • Lipid Metabolism / physiology*
  • Male
  • Psychotic Disorders / blood*
  • Triglycerides / blood

Substances

  • Blood Glucose
  • C-Peptide
  • Glycated Hemoglobin A
  • Insulin
  • Triglycerides
  • hemoglobin A1c protein, human
  • Cholesterol
  • Hydrocortisone