Effect of long-term monotherapy of atypical antipsychotics on the levels of body mass index, leptin concentration and insulin resistance in patients with schizophrenia / 中国药学杂志

ABSTRACT

OBJECTIVE: To compare the effects of clozapine, olanzapine and resperidone on the levels of body mass index (BMI), leptin, fasting insulin concentration(FINS) and insulin resistance(IR) in inpatients with schizophrenia; to investigate the relationship between BMI, leptin, FINS and IR in subjects. METHODS: Seventy-four Chinese inpatients with schizophrenia, treated with monotherapy of clozapine (n=27), risperidone (n=19) and olanzapine (n=13) for at least one year or unmedicated (n=15), were recruited; Levels of BMI, leptin, FINS and were measured, homeostasis model assessment of insulin resistance(HOMA-IR) were performed. RESULTS: Significant difference in the mean levels of BMI was the found between four groups (P<0.05). In post hoc test, it was seen that clozapine and olanzapine-treated patients had higher levels of BMI than those in risperidone and control group; there was a significant difference in the level of leptin (P<0.05), which was the highest in clozapine-treated patients; in the comparison of the mean values of FINS and HOMA-IR levels between four groups, there was no statistically significant difference. There was a positive correlation between BMI and leptin leves, FINs, and HOMA-IR (p<0.05). CONCLUSION: Treatment with clozapine, olanzapine and risperidone is associated with abnormal glucose and lipid metabolism in inpatients with schizophrenia. The positive correlation between BMI and serum leptin, fasting serum insulin levels, HOMA-IR suggests that the increase of serum leptin and fasting serum insulin levels would be an important trait of metabolic syndrome related to monotherapy of treatment with clozapine, olanzapine and risperidone in inpatients with schizophrenia.