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Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment

Background: Schizophrenia (SCZ) and bipolar disorder (BD) are severe mental illnesses (SMI) associated with elevated cardiovascular disease (CVD) risk, including obesity. Leptin and adiponectin are secreted by adipose tissue, with pro- and anti-inflammatory properties, respectively. The second gener...

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Autores principales: Reponen, Elina J., Tesli, Martin, Dieset, Ingrid, Steen, Nils Eiel, Vedal, Trude S. J., Szabo, Attila, Werner, Maren C. F., Lunding, Synve H., Johansen, Ingrid T., Rødevand, Linn N., Andreassen, Ole A., Ueland, Thor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192708/
https://www.ncbi.nlm.nih.gov/pubmed/34122163
http://dx.doi.org/10.3389/fpsyt.2021.623192
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author Reponen, Elina J.
Tesli, Martin
Dieset, Ingrid
Steen, Nils Eiel
Vedal, Trude S. J.
Szabo, Attila
Werner, Maren C. F.
Lunding, Synve H.
Johansen, Ingrid T.
Rødevand, Linn N.
Andreassen, Ole A.
Ueland, Thor
author_facet Reponen, Elina J.
Tesli, Martin
Dieset, Ingrid
Steen, Nils Eiel
Vedal, Trude S. J.
Szabo, Attila
Werner, Maren C. F.
Lunding, Synve H.
Johansen, Ingrid T.
Rødevand, Linn N.
Andreassen, Ole A.
Ueland, Thor
author_sort Reponen, Elina J.
collection PubMed
description Background: Schizophrenia (SCZ) and bipolar disorder (BD) are severe mental illnesses (SMI) associated with elevated cardiovascular disease (CVD) risk, including obesity. Leptin and adiponectin are secreted by adipose tissue, with pro- and anti-inflammatory properties, respectively. The second generation antipsychotics (AP) olanzapine, clozapine, and quetiapine have been associated with high leptin levels in SMI. However, the link between inflammatory dysregulation of leptin and adiponectin and CVD risk in SMI, and how this risk is influenced by body mass and AP medication, is still not completely understood. We investigated herein if leptin, adiponectin or their ratio (L/A ratio) could predict increased CVD risk in SCZ, BD, and in subgroups according to use of antipsychotic (AP) treatment, independent of other cardio-metabolic risk factors. Methods: We measured fasting plasma levels of leptin and adiponectin, and calculated the L/A ratio in n = 1,092 patients with SCZ and BD, in subgroups according to AP treatment, and in n = 176 healthy controls (HC). Differences in the levels of adipokines and L/A between groups were examined in multivariate analysis of covariance, and the correlations between adipokines and body mass index (BMI) with linear regression. CVD risk was defined by total cholesterol/high-density lipoprotein (TC/HDL) and triglyceride/HDL (TG/HDL) ratios. The adipokines and L/A ratios ability to discriminate individuals with TG/HDL and TC/HDL ratios above threshold levels was explored by ROC analysis, and we investigated the possible influence of other cardio-metabolic risk factors on the association in logistic regression analyses. Results: We observed higher leptin levels and L/A ratios in SMI compared with HC but found no differences in adiponectin. Both adipokines were highly correlated with BMI. The low adiponectin levels showed a fair discrimination in ROC analysis of individuals with CVD risk, with AUC between 0.7 and 0.8 for both TC/HDL and TG/HDL, in all groups examined regardless of diagnosis or AP treatment. Adiponectin remained significantly associated with an elevated TC/HDL and TG/HDL ratio in SMI, also after further adjustment with other cardio-metabolic risk factors. Conclusions: Adiponectin is not dysregulated in SMI but is associated with CVD risk regardless of AP treatment regime.
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spelling pubmed-81927082021-06-12 Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment Reponen, Elina J. Tesli, Martin Dieset, Ingrid Steen, Nils Eiel Vedal, Trude S. J. Szabo, Attila Werner, Maren C. F. Lunding, Synve H. Johansen, Ingrid T. Rødevand, Linn N. Andreassen, Ole A. Ueland, Thor Front Psychiatry Psychiatry Background: Schizophrenia (SCZ) and bipolar disorder (BD) are severe mental illnesses (SMI) associated with elevated cardiovascular disease (CVD) risk, including obesity. Leptin and adiponectin are secreted by adipose tissue, with pro- and anti-inflammatory properties, respectively. The second generation antipsychotics (AP) olanzapine, clozapine, and quetiapine have been associated with high leptin levels in SMI. However, the link between inflammatory dysregulation of leptin and adiponectin and CVD risk in SMI, and how this risk is influenced by body mass and AP medication, is still not completely understood. We investigated herein if leptin, adiponectin or their ratio (L/A ratio) could predict increased CVD risk in SCZ, BD, and in subgroups according to use of antipsychotic (AP) treatment, independent of other cardio-metabolic risk factors. Methods: We measured fasting plasma levels of leptin and adiponectin, and calculated the L/A ratio in n = 1,092 patients with SCZ and BD, in subgroups according to AP treatment, and in n = 176 healthy controls (HC). Differences in the levels of adipokines and L/A between groups were examined in multivariate analysis of covariance, and the correlations between adipokines and body mass index (BMI) with linear regression. CVD risk was defined by total cholesterol/high-density lipoprotein (TC/HDL) and triglyceride/HDL (TG/HDL) ratios. The adipokines and L/A ratios ability to discriminate individuals with TG/HDL and TC/HDL ratios above threshold levels was explored by ROC analysis, and we investigated the possible influence of other cardio-metabolic risk factors on the association in logistic regression analyses. Results: We observed higher leptin levels and L/A ratios in SMI compared with HC but found no differences in adiponectin. Both adipokines were highly correlated with BMI. The low adiponectin levels showed a fair discrimination in ROC analysis of individuals with CVD risk, with AUC between 0.7 and 0.8 for both TC/HDL and TG/HDL, in all groups examined regardless of diagnosis or AP treatment. Adiponectin remained significantly associated with an elevated TC/HDL and TG/HDL ratio in SMI, also after further adjustment with other cardio-metabolic risk factors. Conclusions: Adiponectin is not dysregulated in SMI but is associated with CVD risk regardless of AP treatment regime. Frontiers Media S.A. 2021-05-28 /pmc/articles/PMC8192708/ /pubmed/34122163 http://dx.doi.org/10.3389/fpsyt.2021.623192 Text en Copyright © 2021 Reponen, Tesli, Dieset, Steen, Vedal, Szabo, Werner, Lunding, Johansen, Rødevand, Andreassen and Ueland. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Reponen, Elina J.
Tesli, Martin
Dieset, Ingrid
Steen, Nils Eiel
Vedal, Trude S. J.
Szabo, Attila
Werner, Maren C. F.
Lunding, Synve H.
Johansen, Ingrid T.
Rødevand, Linn N.
Andreassen, Ole A.
Ueland, Thor
Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment
title Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment
title_full Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment
title_fullStr Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment
title_full_unstemmed Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment
title_short Adiponectin Is Related to Cardiovascular Risk in Severe Mental Illness Independent of Antipsychotic Treatment
title_sort adiponectin is related to cardiovascular risk in severe mental illness independent of antipsychotic treatment
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192708/
https://www.ncbi.nlm.nih.gov/pubmed/34122163
http://dx.doi.org/10.3389/fpsyt.2021.623192
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