Possible connection between ghrelin, resistin and TNF-alpha levels and the metabolic syndrome caused by atypical antipsychotics

• Published in: Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület lapja Vol. 7; no. 3; p. 132
• Main Authors: Birkás Kováts, Dezso, Palik, Eva, Faludi, Gábor, Cseh, Károly
• Format: Journal Article
• Language: Hungarian
• Published: Hungary 01-09-2005
• Subjects: Antipsychotic Agents - adverse effects; Benzodiazepines - adverse effects; Carbohydrate Metabolism - drug effects; Case-Control Studies; Clozapine - adverse effects; Dibenzothiazepines - adverse effects; Female; Ghrelin; Humans; Insulin Resistance; Male; Metabolic Syndrome - blood; Metabolic Syndrome - chemically induced; Middle Aged; Obesity - blood; Obesity - chemically induced; Overweight - drug effects; Peptide Hormones - adverse effects; Peptide Hormones - blood; Quetiapine Fumarate; Resistin - adverse effects; Resistin - blood; Risperidone - adverse effects; Tumor Necrosis Factor-alpha - adverse effects; Tumor Necrosis Factor-alpha - metabolism; Weight Gain - drug effects
• ISSN: 1419-8711

Second generation antipsychotics (SGA) are obesitogenic and diabetogenic. Role of ghrelin (RIA), resistin and TNF-alpha (ELISA) in weight gain and insulin resistance (fasting plasma insulin, HOMA, ELISA) was studied in Hungarian psychiatryic patients (n=60) treated with SGA (clozapine, olanzapine, risperidone, quetiapine, 15 each). After 1 year, 80% of patients became overweight/obese (BMI > 27/30) and 35% (n= 21/60) presented impaired glucose tolerance (13/60) or diabetes (8/60). Ghrelin (1.3 +/- 0.6 ng/ml), resistin (9.8 +/- 3.7 ng/ml), TNF-alpha (5.8 +/- 1.7 pg/ml), insulin (10.4 +/- 7.6 U/ml, HOMA A: 2.5 +/- 1.8, HOMA B: 133 +/- 62.5) were significantly higher in patients than in healthy matched controls. Resistin and TNF-alpha positively correlated with each other, insulin, HOMA, and negatively with ghrelin. Ghrelin contributes to weight gain, resistin and TNF-alpha to insulin resistance. A negative feedback regulation may exist between adipocytokines and ghrelin production. SGA drugs enhance ghrelin production despite the suppressive effect of adipocytokines. All four SGA drugs are equally obesitogenic and diabetogenic.