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Second-generation antipsychotics and adiponectin levels in schizophrenia: A comparative meta-analysis
Francesco Bartoli1, Cristina Crocamo1, Massimo Clerici1
1Department of Surgery and Translational Medicine, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy.
Summary
Second-generation antipsychotics (SGAs) like clozapine and olanzapine lower adiponectin levels in schizophrenia patients more than risperidone. This may explain increased metabolic issues with these specific SGAs.
Area of Science:
- Pharmacology and Psychiatry
- Metabolic Syndrome Research
- Adipokine Signaling Pathways
Background:
- Second-generation antipsychotics (SGAs) are associated with reduced plasma adiponectin levels in individuals with schizophrenia.
- This adiponectin dysregulation may contribute to metabolic abnormalities observed in patients treated with SGAs.
- The specific impact of different SGAs on adiponectin levels remains incompletely understood.
Purpose of the Study:
- To systematically review and meta-analyze existing data on adiponectin levels in schizophrenia patients treated with various SGAs.
- To compare adiponectin levels across different SGAs, identifying potential differences in their effects on this adipokine.
Main Methods:
- Systematic literature search of observational studies published up to March 2015.
- Inclusion criteria required data on adiponectin from at least three samples with a minimum of five participants per treatment arm for each SGA comparison.
- Standardized mean differences and 95% confidence intervals were calculated; heterogeneity was assessed using I² statistic.
Main Results:
- Eight studies were included, enabling comparisons between Clozapine vs. Olanzapine, Clozapine vs. Risperidone, Olanzapine vs. Risperidone, and Quetiapine vs. Risperidone.
- No significant difference in adiponectin levels was found between Clozapine and Olanzapine, though high heterogeneity was noted.
- Clozapine and Olanzapine were associated with significantly lower adiponectin levels compared to Risperidone; Quetiapine showed no significant difference versus Risperidone.
Conclusions:
- Findings align with evidence linking Clozapine and Olanzapine to greater metabolic abnormalities compared to other SGAs.
- Reduced adiponectin levels associated with Clozapine and Olanzapine may mediate these metabolic disturbances.
- Further prospective studies are required to elucidate the long-term effects of different SGAs on adiponectin and associated metabolic outcomes.
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