Abnormal glycemic homeostasis at the onset of serious mental illnesses: A common pathway
Clemente Garcia-Rizo1, Brian Kirkpatrick2, Emilio Fernandez-Egea3
1Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain; Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Insights
Patients with serious mental illnesses have higher glucose levels at disease onset, indicating an abnormal metabolic pathway. Early intervention is crucial for preventing related medical conditions like type 2 diabetes.
Area of Science:
- Neuroscience
- Metabolic Disorders
- Psychiatry
Background:
- Serious mental illnesses are linked to reduced lifespan, with medical conditions like type 2 diabetes and cardiovascular disease being primary causes of death.
- While lifestyle and treatment factors are considered, the role of underlying metabolic changes at disease onset requires further investigation.
Purpose of the Study:
- To investigate glucose metabolism in patients newly diagnosed with serious mental illnesses before pharmacological treatment.
- To compare glucose load in first-episode schizophrenia, bipolar disorder, and major depressive disorder patients with adjustment disorder and healthy controls.
Main Methods:
- A two-hour glucose load test was administered to 102 patients with first-episode serious mental illness (schizophrenia, bipolar disorder, major depression).
- The study included 17 patients with adjustment disorder and 98 matched controls for comparison.
- Glucose levels were measured at two hours post-load.
Main Results:
- Patients with serious mental illness exhibited significantly higher two-hour glucose loads compared to both adjustment disorder and control groups (p<0.001).
- Mean two-hour glucose values were notably elevated in schizophrenia, bipolar disorder, and major depressive disorder cohorts.
- Specifically, values for schizophrenia, bipolar disorder, and major depressive disorder were 106.51mg/dL, 118.33mg/dL, and 107.42mg/dL, respectively, versus 79.06mg/dL and 82.11mg/dL for adjustment disorder and controls.
Conclusions:
- The findings suggest an abnormal glycemic pathway present at the disease onset of serious mental illnesses, independent of pharmacological treatment or other confounding factors.
- This indicates a potential shared metabolic vulnerability across these conditions.
- The study underscores the need for early primary and secondary prevention strategies targeting metabolic health in individuals with serious mental illness.
Objective:
Patients with serious mental illnesses exhibit a reduced lifespan compared with the general population, a finding that can not solely rely on high suicide risk, low access to medical care and unhealthy lifestyle. The main causes of death are medical related pathologies such as type 2 diabetes mellitus and cardiovascular disease; however pharmacological treatment might play a role.
Material And Methods:
We compared a two hour glucose load in naïve patients at the onset of a serious mental illness (N=102) (84 patients with a first episode of schizophrenia and related disorders, 6 with a first episode of bipolar I disorder and 12 with a first episode of major depression disorder) with another psychiatric diagnose, adjustment disorder (N=17) and matched controls (N=98).
Results:
Young patients with serious mental illness showed an increased two hour glucose load compared with adjustment disorder and the control group. Mean two hour glucose values [±standard deviation] were: for schizophrenia and related disorders 106.51mg/dL [±32.0], for bipolar disorder 118.33mg/dL [±34.3], for major depressive disorder 107.42mg/dL [±34.5], for adjustment disorder 79.06mg/dL[±24.4] and for the control group 82.11mg/dL [±23.3] (p<0.001).
Conclusions:
Our results reflect an abnormal metabolic pathway at the onset of the disease before any pharmacological treatment or other confounding factors might have taken place. Our results suggest a similar glycemic pathway in serious mental illnesses and the subsequent need of primary and secondary prevention strategies.
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