Identification of serum metabolic traits of AIWG in first-episode schizophrenia patients

Abstract Background Antipsychotic-induced weight gain (AIWG) is a common side effect of antipsychotic drugs and may lead to cardiometabolic comorbidities. There is an urgent public health need to identify patients at high risk of AIWG and determine potential biomarkers for AIWG. Methods In the Seque...

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Main Authors: Suzhen Zhang, Zhaolin Zhai, Tianhao Gao, Xinping Kuai, Xuan Li, Yuke Dong, Chang Lu, Kaiming Zhuo, Qiong Xiang, Dengtang Liu
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-024-06413-8
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author Suzhen Zhang
Zhaolin Zhai
Tianhao Gao
Xinping Kuai
Xuan Li
Yuke Dong
Chang Lu
Kaiming Zhuo
Qiong Xiang
Dengtang Liu
author_facet Suzhen Zhang
Zhaolin Zhai
Tianhao Gao
Xinping Kuai
Xuan Li
Yuke Dong
Chang Lu
Kaiming Zhuo
Qiong Xiang
Dengtang Liu
author_sort Suzhen Zhang
collection DOAJ
description Abstract Background Antipsychotic-induced weight gain (AIWG) is a common side effect of antipsychotic drugs and may lead to cardiometabolic comorbidities. There is an urgent public health need to identify patients at high risk of AIWG and determine potential biomarkers for AIWG. Methods In the Sequential Multiple-Assignment Randomized Trials to Compare Antipsychotic Treatments (SMART-CAT) trail, first-episode schizophrenia patients were randomly assigned to olanzapine, risperidone, perphenazine, amisulpride or aripiprazole for 8 weeks. We applied absolute quantitative lipidomics at baseline and after 8 weeks of antipsychotic treatment in 80 patients. To evaluate the effects of AIWG on lipid profile, 25 patients with ≥ 7% weight changes (weight gain, WG) and 28 patients with <|3|% weight changes (weight stable, WS) were investigated, separately. Results We found that baseline CerP(d40:3) and PC(20:1_22:6) were positively associated with weight changes at follow-up (r > 0.4, pFDR < 0.05). Additionally, baseline CerP(d40:3) and PC(20:1_22:6) independently predicted rapid weight gain, with receiver operating curve (ROC) of 0.76 (95% CI: 0.63–0.90), and 0.75 (95% CI: 0.62–0.88), respectively. Compared with baseline, levels of 45 differential lipid metabolites (fold change > 1.2, VIP > 1 and pFDR < 0.05) were significantly higher in the WG group. Interestingly, no differential lipid metabolites were identified in the WS group. The LASSO regression model identified 18 AIWG lipid signatures, including 2 cholesterol esters (ChEs), 1 diglyceride (DG), 12 phosphatidylcholines (PCs), 1 phosphatidylglycerol (PG), 1 phosphatidylinositol (PI), and 1 sphingomyelin (SM), with the ChE(16:1) contributing the most. Furthermore, the level changes of ChE(16:1) were positively associated with weight gain(r = 0.67, pFDR < 0.05). Conclusion Our findings indicate that lipid profile may serve as predictors of rapid weight gain in schizophrenia and provide useful markers for AIWG intervention.
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spelling doaj-art-af22e4637fc742dfaed7e79e8afd7cab2024-12-29T12:40:19ZengBMCBMC Psychiatry1471-244X2024-12-012411910.1186/s12888-024-06413-8Identification of serum metabolic traits of AIWG in first-episode schizophrenia patientsSuzhen Zhang0Zhaolin Zhai1Tianhao Gao2Xinping Kuai3Xuan Li4Yuke Dong5Chang Lu6Kaiming Zhuo7Qiong Xiang8Dengtang Liu9Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineDivision of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineAbstract Background Antipsychotic-induced weight gain (AIWG) is a common side effect of antipsychotic drugs and may lead to cardiometabolic comorbidities. There is an urgent public health need to identify patients at high risk of AIWG and determine potential biomarkers for AIWG. Methods In the Sequential Multiple-Assignment Randomized Trials to Compare Antipsychotic Treatments (SMART-CAT) trail, first-episode schizophrenia patients were randomly assigned to olanzapine, risperidone, perphenazine, amisulpride or aripiprazole for 8 weeks. We applied absolute quantitative lipidomics at baseline and after 8 weeks of antipsychotic treatment in 80 patients. To evaluate the effects of AIWG on lipid profile, 25 patients with ≥ 7% weight changes (weight gain, WG) and 28 patients with <|3|% weight changes (weight stable, WS) were investigated, separately. Results We found that baseline CerP(d40:3) and PC(20:1_22:6) were positively associated with weight changes at follow-up (r > 0.4, pFDR < 0.05). Additionally, baseline CerP(d40:3) and PC(20:1_22:6) independently predicted rapid weight gain, with receiver operating curve (ROC) of 0.76 (95% CI: 0.63–0.90), and 0.75 (95% CI: 0.62–0.88), respectively. Compared with baseline, levels of 45 differential lipid metabolites (fold change > 1.2, VIP > 1 and pFDR < 0.05) were significantly higher in the WG group. Interestingly, no differential lipid metabolites were identified in the WS group. The LASSO regression model identified 18 AIWG lipid signatures, including 2 cholesterol esters (ChEs), 1 diglyceride (DG), 12 phosphatidylcholines (PCs), 1 phosphatidylglycerol (PG), 1 phosphatidylinositol (PI), and 1 sphingomyelin (SM), with the ChE(16:1) contributing the most. Furthermore, the level changes of ChE(16:1) were positively associated with weight gain(r = 0.67, pFDR < 0.05). Conclusion Our findings indicate that lipid profile may serve as predictors of rapid weight gain in schizophrenia and provide useful markers for AIWG intervention.https://doi.org/10.1186/s12888-024-06413-8SchizophreniaAntipsychoticWeight gainLipid
spellingShingle Suzhen Zhang
Zhaolin Zhai
Tianhao Gao
Xinping Kuai
Xuan Li
Yuke Dong
Chang Lu
Kaiming Zhuo
Qiong Xiang
Dengtang Liu
Identification of serum metabolic traits of AIWG in first-episode schizophrenia patients
BMC Psychiatry
Schizophrenia
Antipsychotic
Weight gain
Lipid
title Identification of serum metabolic traits of AIWG in first-episode schizophrenia patients
title_full Identification of serum metabolic traits of AIWG in first-episode schizophrenia patients
title_fullStr Identification of serum metabolic traits of AIWG in first-episode schizophrenia patients
title_full_unstemmed Identification of serum metabolic traits of AIWG in first-episode schizophrenia patients
title_short Identification of serum metabolic traits of AIWG in first-episode schizophrenia patients
title_sort identification of serum metabolic traits of aiwg in first episode schizophrenia patients
topic Schizophrenia
Antipsychotic
Weight gain
Lipid
url https://doi.org/10.1186/s12888-024-06413-8
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