Protective Effects of Quetiapine on Metabolic and Inflammatory Abnormalities in Schizophrenic Patients during Exacerbated Stage

Yu-Chen Kao ； Chih-Yuan Ko ； Sheng-Chiang Wang ； Yia-Ping Liu

《The Chinese Journal of Physiology》 59卷2期 (2016/04) Pp. 69-77

https://doi.org/10.4077/CJP.2016.BAE370

並列摘要

Inflammation has been considered important in the pathogenesis of schizophrenia. Increasing evidence reveals that patients with schizophrenia have abnormal expression of cytokines, which are related to development of metabolic abnormalities. Metabolic abnormality has become a critical issue, though its longitudinal relationship with the disorder, such as the antipsychotics influence, is unclear. We aimed to investigate whether abnormalities of metabolic parameters and cytokine levels in acute exacerbated schizophrenic patients existed, and whether intervention of antipsychotic could help. The present study analyzed peripheral cytokines and metabolic/hemodynamic parameters in healthy controls and acute exacerbated schizophrenic patients hospitalized for three weeks under the unique treatment of quetiapine, a well-known second-generation antipsychotic. Our results showed that patients with schizophrenia were predisposed to metabolic abnormalities in acute exacerbation, including body mass index (BMI) and waist circumference (WC). The patients were also prone to dysglycemia, lower high-density lipoprotein cholesterol (HDL-c) levels, and higher blood pressure with concomitant of elevation of interleukin (IL)-2, IL-6 and IL-10 in which IL-6 was associated with BMI. After quetiapine treatment, IL-2, IL-6 and IL-10 remained higher than the controls, but IL-10 was significantly decreased in follow-up comparison. Glycemic-related indexes, HDL-c and IL-10 levels were significantly changed by variance analysis. Results of the present study imply that acute exacerbated schizophrenic patients with metabolism abnormalities may involve disruption of expression of cytokines, and that quetiapine may have therapeutic effects. Nonetheless, metabolism parameters of patients undergoing treatment with quetiapine should be closely monitored.

並列關鍵字

cytokines ； inflammation ； metabolic abnormalities ； quetiapine ； schizophrenia

參考文獻

Abidin, Z.,Davoren, M.,Naughton, L.,Gibbons, O.,Nulty, A.,Kennedy, H.G.(2013).Susceptibility (risk and protective) factors for inpatient violence and self-harm: prospective study of structured professional judgement instruments START and SAPROF, DUNDRUM-3 and DUNDRUM-4 in forensic mental health services.BMC Psychiatry.13,197.

Afsar, B.(2015).Disruption of circadian blood pressure, heart rate and the impact on glycemic control in type 1 diabetes.Diabetes Metab. Syndr..9,359-363.

Amsen, D.,de Visser, K.E.,Town, T.(2009).Approaches to determine expression of inflammatory cytokines.Methods Mol. Biol..511,107-142.

Ansell, B.J.(2005).Evidence for a combined approach to the management of hypertension and dyslipidemia.Am. J. Hypertens..18,1249-1257.

Bautista, L.E.,Vera, L.M.,Arenas, I.A.,Gamarra, G.(2005).Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-α) and essential hypertension.J. Hum. Hypertens..19,149-154.