Prevalence and clinical correlates of impaired glucose tolerance in first‐episode versus chronic patients with schizophrenia

BackgroundSchizophrenia patients have a higher prevalence of type 2 diabetes mellitus with impaired glucose tolerance (IGT) than normals. We examined the relationship between IGT and clinical phenotypes or cognitive deficits in first-episode, drug-naïve (FEDN) Han Chinese patients with schizophrenia.MethodA total of 175 in-patients were compared with 31 healthy controls on anthropometric measures and fasting plasma levels of glucose, insulin and lipids. They were also compared using a 75 g oral glucose tolerance test and the homeostasis model assessment of insulin resistance (HOMA-IR). Neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).ResultsOf the patients, 24.5% had IGT compared with none of the controls, and they also had significantly higher levels of fasting blood glucose and 2-h glucose after an oral glucose load, and were more insulin resistant. Compared with those patients with normal glucose tolerance, the IGT patients were older, had a later age of onset, higher waist or hip circumference and body mass index, higher levels of low-density lipoprotein and triglycerides and higher insulin resistance. Furthermore, IGT patients had higher PANSS total and negative symptom subscale scores, but no greater cognitive impairment except on the emotional intelligence index of the MCCB.ConclusionsIGT occurs with greater frequency in FEDN schizophrenia, and shows association with demographic and anthropometric parameters, as well as with clinical symptoms but minimally with cognitive impairment during the early course of the disorder.

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Impaired glucose tolerance in first-episode drug-naïve patients with schizophrenia

Diabetic Medicine ◽

10.1111/j.1464-5491.2007.02092.x ◽

2007 ◽

Vol 24 (5) ◽

pp. 481-485 ◽

Cited By ~ 243

Author(s):

L. M. Spelman ◽

P. I. Walsh ◽

N. Sharifi ◽

P. Collins ◽

J. H. Thakore

Keyword(s):

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

First Episode ◽

Drug Naïve

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The association between first-episode psychosis and abnormal glycaemic control: Systematic review and meta-analysis of clinical studies

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1619 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s827-s827

Author(s):

B. Perry ◽

G. McIntosh ◽

S. Weich ◽

S. Singh ◽

K. Rees

Keyword(s):

Insulin Resistance ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Meta Analysis ◽

First Episode Psychosis ◽

Mean Difference ◽

First Episode ◽

Case Control Studies ◽

Number Of Patients ◽

Episode Psychosis

BackgroundSchizophrenia, which is linked to a range of physical health conditions, might share intrinsic inflammatory disease pathways with type-two diabetes mellitus (T2DM). Psychotropic medication has presented a major confounder in examining this association. First-episode psychosis (FEP) patients present an interesting cohort to study this potential association, being generally younger with less comorbidity, and with limited exposure to antipsychotic medication.AimsTo assess whether FEP, which could be described as ‘developing schizophrenia’, is associated with prediabetes, or ‘developing diabetes’, to determine whether intrinsic disease links could cause the conditions to develop in unison.MethodsUsing PRISMA criteria, we searched Embase, Medline, PsychInfo, Web of Science, and Google Scholar to 6th January 2016. We assessed case-control studies with biochemical assessment of prediabetic states in FEP patients alongside matched controls.ResultsTwelve studies were included, involving 1137 participants. Several measurements examined prediabetes, including fasting plasma glucose, impaired glucose tolerance, and insulin resistance. Pooled analysis found FEP to be related to impaired glucose tolerance (mean difference 1.31 [0.37, 2.25]), insulin resistance (mean difference 0.30 [0.18, 0.42]), and the number of patients with impaired glucose tolerance (odds ratio 5.44 [2.63–11.27]).ConclusionOur findings suggest a potential link between prediabetic markers, in particular impaired glucose tolerance and insulin resistance, and FEP. However, we cannot establish causality, and the studies contributing to this review were at some risk of bias. Nevertheless, the findings might help to explain the increased prevalence of T2DM in patients with schizophrenia and could have implications for the management of schizophrenia patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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