Association of adiponectin and metabolic syndrome among patients taking atypical antipsychotics for schizophrenia: A cohort study

Abstract

Introduction: Adiponectin, an adipocyte-derived hormone controlling lipid and carbohydrate metabolism, has been suggested to be a biomarker for metabolic syndrome in the general population. This study investigated the association between adiponectin levels and metabolic syndrome in patients treated with atypical antipsychotics. Methods: Anthropometric and metabolic parameters and serum adiponectin levels were assessed in hospitalized patients with schizophrenia who had used the same atypical antipsychotic for at least 3?months. Retrospective reviews of the patients' medical records were conducted to obtain demographic data and pretreatment characteristics. Results: The study included 567 schizophrenia patients treated with clozapine (n = 231), olanzapine (n = 94) and risperidone (n = 242), for an average of 45.8 ± 27.8?months. The prevalence of metabolic syndrome among all subjects was 23.8%. The clozapine group had a higher prevalence of metabolic syndrome (28.7%) than did the olanzapine (24.2%) and risperidone groups (19.5%) (P = 0.039), and the clozapine group had lower levels of adiponectin (8.46 ± 6.02?mg/mL) than did the olanzapine (10.26 ± 4. 9?mg/mL) and risperidone groups (10.69 ± 7.43?mg/mL) (P = 0.001). Adiponectin level was negatively correlated with body mass index (BMI) increase after initiation of antipsychotic treatment. Cross-sectional regression analysis showed that age (OR, = 1.042, P = 0.001), BMI (OR = 1.404, P < 0.0001), and adiponectin level (OR = 0.862, P < 0.0001) were significant factors in the presence of metabolic syndrome. Significant predictors of metabolic syndrome were age at initiation of antipsychotic treatment (OR = 1.04, P = .007), BMI at initiation of antipsychotic treatment (OR = 1.44, P < 0.0001), BMI increase after initiation of antipsychotic treatment (OR = 1.40, P < 0.0001), and adiponectin level (OR = 0.86, P < 0.0001). Conclusion: Lower levels of adiponectin and weight gain after taking antipsychotics are associated with higher risk of metabolic syndrome in patients taking atypical antipsychotics. Crown Copyright ? 2009.