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Impaired glucose tolerance in first-episode drug-naïve patients with schizophrenia: relationships with clinical phenotypes and cognitive deficits

Published online by Cambridge University Press:  08 September 2016

D. C. Chen ,
X. D. Du ,
G. Z. Yin ,
K. B. Yang ,
Y. Nie ,
N. Wang ,
Y. L. Li ,
M. H. Xiu ,
S. C. He  and
F. D. Yang
...Show all authors
D. C. Chen
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China
X. D. Du
Affiliation:
Suzhou Psychiatric Hospital, Suzhou, Jiangsu Province, People's Republic of China
G. Z. Yin
Affiliation:
Suzhou Psychiatric Hospital, Suzhou, Jiangsu Province, People's Republic of China
K. B. Yang
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China
Y. Nie
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China
N. Wang
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China
Y. L. Li
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China
M. H. Xiu
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China
S. C. He
Affiliation:
Department of Psychology, Peking University, Beijing, People's Republic of China
F. D. Yang
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China
R. Y. Cho
Affiliation:
Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
T. R. Kosten
Affiliation:
Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
J. C. Soares
Affiliation:
Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
J. P. Zhao
Affiliation:
Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
X. Y. Zhang*
Affiliation:
Beijing HuiLongGuan Hospital, Peking University, Beijing, People's Republic of China Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
*
*Address for correspondence: X. Y. Zhang, M.D., Ph.D., UT Center of Excellence on Mood Disorders (UTCEMD), Biomedical and Behavioral Sciences Building (BBSB), 1941 East Road, Houston, TX 77054, USA. (Email: xiang.y.zhang@uth.tmc.edu)
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Abstract

Background

Schizophrenia patients have a higher prevalence of type 2 diabetes mellitus with impaired glucose tolerance (IGT) than normals. We examined the relationship between IGT and clinical phenotypes or cognitive deficits in first-episode, drug-naïve (FEDN) Han Chinese patients with schizophrenia.

Method

A total of 175 in-patients were compared with 31 healthy controls on anthropometric measures and fasting plasma levels of glucose, insulin and lipids. They were also compared using a 75 g oral glucose tolerance test and the homeostasis model assessment of insulin resistance (HOMA-IR). Neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).

Results

Of the patients, 24.5% had IGT compared with none of the controls, and they also had significantly higher levels of fasting blood glucose and 2-h glucose after an oral glucose load, and were more insulin resistant. Compared with those patients with normal glucose tolerance, the IGT patients were older, had a later age of onset, higher waist or hip circumference and body mass index, higher levels of low-density lipoprotein and triglycerides and higher insulin resistance. Furthermore, IGT patients had higher PANSS total and negative symptom subscale scores, but no greater cognitive impairment except on the emotional intelligence index of the MCCB.

Conclusions

IGT occurs with greater frequency in FEDN schizophrenia, and shows association with demographic and anthropometric parameters, as well as with clinical symptoms but minimally with cognitive impairment during the early course of the disorder.

Keywords

Cognitiondrug-naïve patientsfirst-episode schizophreniaglycometabolismpsychopathology
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 15 , November 2016 , pp. 3219 - 3230
Copyright
Copyright © Cambridge University Press 2016 

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