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Br J Psychiatry. 2017 Dec;211(6):339-349. doi: 10.1192/bjp.bp.117.200907. Epub 2017 Oct 5.

Cholesterol and triglyceride levels in first-episode psychosis: systematic review and meta-analysis.

Author information

1
Toby Pillinger, MRCP, Katherine Beck, MRCPsych, Brendon Stubbs, PhD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and South London and Maudsley National Health Service (NHS) Foundation Trust, London; Oliver D. Howes, PhD MRCPsych, Institute of Psychiatry, Psychology and Neuroscience, King's College London, South London and Maudsley NHS Foundation Trust, Medical Research Council London Institute of Medical Sciences, Hammersmith Hospital, and Institute of Clinical Sciences, Faculty of Medicine, Imperial College, London, UK toby.pillinger@kcl.ac.uk.
2
Toby Pillinger, MRCP, Katherine Beck, MRCPsych, Brendon Stubbs, PhD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and South London and Maudsley National Health Service (NHS) Foundation Trust, London; Oliver D. Howes, PhD MRCPsych, Institute of Psychiatry, Psychology and Neuroscience, King's College London, South London and Maudsley NHS Foundation Trust, Medical Research Council London Institute of Medical Sciences, Hammersmith Hospital, and Institute of Clinical Sciences, Faculty of Medicine, Imperial College, London, UK.

Abstract

BackgroundThe extent of metabolic and lipid changes in first-episode psychosis (FEP) is unclear.AimsTo investigate whether individuals with FEP and no or minimal antipsychotic exposure show lipid and adipocytokine abnormalities compared with healthy controls.MethodWe conducted a meta-analysis of studies examining lipid and adipocytokine parameters in individuals with FEP and no or minimal antipsychotic exposure v. a healthy control group. Studies reported fasting total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and leptin levels.ResultsOf 2070 citations retrieved, 20 case-control studies met inclusion criteria including 1167 patients and 1184 controls. Total cholesterol and LDL cholesterol levels were significantly decreased in patients v. controls, corresponding to an absolute reduction of 0.26 mmol/L and 0.15 mmol/L respectively. Triglyceride levels were significantly increased in the patient group, corresponding to an absolute increase of 0.08 mmol/L. However, HDL cholesterol and leptin levels were not altered in patients v. controls.ConclusionsTotal and LDL cholesterol levels are reduced in FEP, indicating that hypercholesterolaemia in patients with chronic disorder is secondary and potentially modifiable. In contrast, triglycerides are elevated in FEP. Hypertriglyceridaemia is a feature of type 2 diabetes mellitus, therefore this finding adds to the evidence for glucose dysregulation in this cohort. These findings support early intervention targeting nutrition, physical activity and appropriate antipsychotic prescription.

PMID:
28982658
PMCID:
PMC5709673
DOI:
10.1192/bjp.bp.117.200907
[Indexed for MEDLINE]
Free PMC Article

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