Abstract
PurposeAlterations in one-carbon metabolism (OCM) have been repeatedly reported in schizophrenia. However, there is a scarcity of studies addressing the effects of antipsychotics on selected OCM markers in schizophrenia and provided results are inconsistent.MethodsWe recruited 39 first-episode schizophrenia (FES) patients and determined serum profile of total homocysteine (tHcy), folate, vitamin B12, lipoproteins and glucose at baseline and after 12 weeks of treatment with second-generation antipsychotics (SGA) including olanzapine and risperidone in monotherapy.ResultsAfter 12 weeks of treatment, all patients had significantly higher body mass index (BMI), serum levels of total cholesterol (TC), low-density lipoproteins (LDL), triglycerides (TG) and tHcy together with significantly lower levels of folate and vitamin B12. The analysis of differences between SGA revealed the same biochemical alterations in patients treated with olanzapine as in the whole group, while those receiving risperidone had no statistically significant changes in serum folate, vitamin B12 and TG. There was a significantly higher increase in BMI and TC in patients treated with olanzapine in comparison with those treated with risperidone. Patients receiving olanzapine had a higher decrease in vitamin B12 than those assigned to the treatment with risperidone. Changes in folate, vitamin B12, tHcy and TC levels were significant only in males, even after Bonferroni correction. Multiple regression analysis revealed that changes in tHcy levels are associated with gender and baseline metabolic parameters (BMI, glucose, TC, LDL and HDL) but not with selected SGA.ConclusionsThese results indicate that SGA may influence OCM, especially in first-episode schizophrenia (FES) males.Electronic supplementary materialThe online version of this article (doi:10.1007/s00228-014-1762-2) contains supplementary material, which is available to authorized users.
Highlights
Life expectancy in schizophrenia patients is about 20 years shorter in comparison with the general population [1]
Multiple regression analysis revealed that changes in total homocysteine (tHcy) levels are associated with gender and baseline metabolic parameters (BMI, glucose, total cholesterol (TC), low-density lipoproteins (LDL) and high-density lipoproteins (HDL)) but not with selected second-generation antipsychotics (SGA). These results indicate that SGA may influence One-carbon metabolism (OCM), especially in first-episode schizophrenia (FES) males
It has been found that schizophrenia patients with positive family history of schizophrenia are characterized by significantly higher Hcy and lower vitamin B12 levels in comparison to those without first-degree relatives with schizophrenia [4]. These findings suggest the role of genetic factors in OCM alterations in schizophrenia and are in line with the plethora of studies showing the association between two functional polymorphisms (C677T and A1298C) in the methylenetetrahydrofolate reductase (MTHFR) gene and schizophrenia risk [12, 13]
Summary
Life expectancy in schizophrenia patients is about 20 years shorter in comparison with the general population [1]. This mortality gap has been widely attributed to high prevalence rates of medical comorbidities, mainly the metabolic syndrome (MetS), which is a clustering of conditions that increase cardiovascular risk including visceral obesity, impaired glucose metabolism, lipid profile disturbances and hypertension. There are studies indicating significantly higher prevalence of MetS among schizophrenia patients in comparison with the general population [2]. Accumulating evidence indicates that even drugnaïve first-episode schizophrenia (FES) patients show signs of subclinical metabolic deregulation [4,5,6,7,8].
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