A randomized, 12-week study of the effects of extended-release paliperidone (paliperidone ER) and olanzapine on metabolic profile, weight, insulin resistance, and β-cell function in schizophrenic patients

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• 作者：Shaohua Hu ; Mingrong Yao ; Bradley S. Peterson ; Dongrong Xu ; Jianbo Hu…
• 关键词：Metabolic syndrome ; Antipsychotic ; Paliperidone ; Olanzapine ; Insulin resistance ; β ; Cell function
• 刊名：Psychopharmacology
• 出版年：2013
• 出版时间：November 2013
• 年：2013
• 卷：230
• 期：1
• 页码：3-13
• 全文大小：215KB
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• 作者单位：Shaohua Hu (1)
  Mingrong Yao (2)
  Bradley S. Peterson (3)
  Dongrong Xu (3)
  Jianbo Hu (1)
  Jianliang Tang (2)
  Bing Fan (4)
  Zhengluan Liao (5)
  Tianyi Yuan (2)
  Yaling Li (2)
  Weiqing Yue (2)
  Ning Wei (1)
  Weihua Zhou (1)
  Manli Huang (1)
  Yi Xu (1)
  
  1. Department of Mental Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
  2. Department of Psychiatry, Kangci Hospital of Jiaxing, Tongxiang, 314500, China
  3. Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, 10032, USA
  4. Department of Child Epidemic Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, 10032, USA
  5. Department of Psychiatry, Zhejiang Provincial People’s Hospital, Hangzhou, 310014, China
  
• ISSN：1432-2072

文摘

Objective To compare matched paliperidone-ER- and olanzapine-treated schizophrenic patients on measures of glucose and lipid metabolism. Methods Eighty hospitalized patients with schizophrenia (DSM-IV) were randomly assigned to treatment with paliperidone ER or olanzapine for a period of 12?weeks. At baseline and every 4?weeks, we assessed weight, subcutaneous fat, waist and hip circumferences, fasting glucose, insulin, glycohemoglobin A1, cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, and prolactin. We also assessed at every time point body mass index (BMI), homeostasis insulin resistance (HOMA-IR), and homeostasis β-cell function (HOMA-B). Results Thirty-three patients randomly assigned to paliperidone ER and 23 patients randomly assigned to olanzapine groups completed the entire 12-week treatment. Within-group analyses showed that fasting measures in both groups increased for weight, BMI, waist circumferences, hip circumference, subcutaneous fat, cholesterol, triglycerides, and prolactin. In contrast, fasting glucose, LDL, and HOMA-B increased during treatment only in the olanzapine group. We also detected significantly different serum prolactin levels at all time point between the paliperidone ER- and olanzapine-treated groups, as well as a statistical trend for HOMA-B to increase more in the olanzapine compared to paliperidone-ER group over the 12?weeks of the trial. We did not detect, however, differential drug effects over the 12?weeks of the trial on fasting measures of BMI, glucose, glycohemoglobin A1, insulin, HDL, LDL, cholesterol, triglyceride, or HOMA-IR. Conclusion This study reinforces the necessity of regularly monitoring metabolic parameters in patients with schizophrenia taking atypical antipsychotics, including paliperidone ER.