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

The extent of metabolic and lipid changes in first-episode psychosis (FEP) is unclear. To investigate whether individuals with FEP and no or minimal antipsychotic exposure show lipid and adipocytokine abnormalities compared with healthy controls. We conducted a meta-analysis of studies examining lip...

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Bibliographic Details
Published in:British journal of psychiatry Vol. 211; no. 6; pp. 339 - 349
Main Authors: Pillinger, Toby, Beck, Katherine, Stubbs, Brendon, Howes, Oliver D.
Format: Journal Article
Language:English
Published: Cambridge, UK Cambridge University Press 01.12.2017
Royal College of Psychiatrists
Subjects:
Antipsychotics
Cardiovascular disease
Cholesterol
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Chronic illnesses
Citations
Density
Diabetes
Diabetes mellitus (non-insulin dependent)
Early intervention
Fasting
Glucose
Health care access
High density lipoprotein
Hormones
Humans
Hypercholesterolemia
Insulin resistance
Leptin
Leptin - blood
Lipids
Lipoproteins
Low density lipoprotein
Meta-analysis
Metabolic syndrome
Mortality
Nutrition
Patients
Physical activity
Physical fitness
Psychiatry
Psychosis
Psychotic Disorders - blood
Psychotropic drugs
Review
Review article
Schizophrenia
Systematic review
Triglycerides
Triglycerides - blood
Type 2 diabetes mellitus
ISSN:0007-1250, 1472-1465, 1472-1465
Online Access:Get full text
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Summary:The extent of metabolic and lipid changes in first-episode psychosis (FEP) is unclear. To investigate whether individuals with FEP and no or minimal antipsychotic exposure show lipid and adipocytokine abnormalities compared with healthy controls. We conducted a meta-analysis of studies examining lipid and adipocytokine parameters in individuals with FEP and no or minimal antipsychotic exposure a healthy control group. Studies reported fasting total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and leptin levels. Of 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 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 controls. Total 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.
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ISSN:0007-1250
1472-1465
1472-1465
DOI:10.1192/bjp.bp.117.200907