Schizophrenia Spectrum and Psychotic Disorders

Trends in Adipokine Levels After Short-Term Antipsychotic Therapy Among First-Episode, Drug-Naive Psychosis

Jessica Nye, PhD
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Adipokine-illustration
Adiponectin (also referred to as GBP-28, apM1, AdipoQ and Acrp30) is a protein hormone and adipokine, which is involved in regulating glucose levels as well as fatty acid breakdown. 3D cartoon model, white background.
For this study, patients with new-onset schizophrenia, schizophreniform disorder, or brief psychotic episode were recruited from the University Hospital of Ioannina in Greece between 2018 and 2020.

Drug-naive, first-episode patients with psychosis were found to have elevated adiponectin, leptin, and resistin levels compared with healthy controls. These findings were published in the Journal of Psychosomatic Research.

Patients (n=40) with new-onset schizophrenia, schizophreniform disorder, or brief psychotic episode were recruited from the University Hospital of Ioannina in Greece between 2018 and 2020. Blood samples were evaluated by enzyme linked immunosorbent assay and compared with matched controls (n=40).

Patients and controls were aged median 32 (range, 19-40) and 31 (range, 20-40) years, 24 and 24 were men, and mean BMI was 22.6 (SD, 1.1) and 22.4 (SD, 1.3) kg/m2, respectively.

Compared with controls, patients had significantly higher adiponectin (median, 4.410 vs 2.629 ng/mL; P <.0001), leptin (median, 4.298 vs 3.507 pg/mL; P <.0001), and resistin (mean, 4.122 vs 3.645 pg/mL; P <.0001) levels at baseline.

After 6 weeks of antipsychotic treatment, the patients had a mean decrease in leptin of -0.40 pg/mL (P <.0001). For adiponectin and resistin levels, there was a large heterogeneity in the response to treatment, with no clear trends.

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In a multivariate analysis, leptin and resistin levels were inversely related among both patients and controls (β, -0.22; P =.02).

After treatment there were significant decreases to Positive and Negative Syndrome Scale (PANSS) positive (mean, 32.2 vs 7.5 points; P <.0001), negative (mean, 20.2 vs 18.6 points; P =.03), general psychopathology (mean, 26.2 vs 19.6 points; P <.0001), and total (mean, 78.6 vs 45.7 points; P <.0001) scores.

This study may have been limited, as a proportion of the controls had adipokine levels that were below the detection level.

The study authors concluded, “In our study we found higher levels of adiponectin, leptin and resistin in drug-naive, first-episode patients with normal BMI. After 6 weeks of antipsychotic treatment, there was no change in adiponectin and resistin levels, while leptin levels were reduced compared to baseline. Overall, our findings provide further evidence that adiponectin, leptin and resistin reflect sub-threshold metabolic dysregulations and may play a role in the inflammatory changes at the onset of schizophrenia.”

Reference

Petrikis P, Karampas A, Leondaritis G, et al. Adiponectin, leptin and resistin levels in first-episode, drug-naive patients with psychosis before and after short-term antipsychotic treatment. J Psychosom Res. 2022;157:110789. doi:10.1016/j.jpsychores.2022.110789