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Objective It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. Methods We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naive, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs. Results Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5% v.s. 14.9%, 9.2% v.s. 18.4%, 8.1% v.s. 14.9%, 8.6% v.s.18.3%, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9% v.s. 6.4%). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23 days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy. Conclusion These results indicated an early-onset nature of HDL-C abnormalities in drug-naive FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.

Objective and method We performed a case-control study, which included antipsychotic-naive first-episode schizophrenia (FES) of adolescents and young adults and general population controls, to investigate the early-onset cardiometabolic risk factors in FES. Results FES had more frequent lower HDL-C when compared to controls. However, the distribution of BMI and the frequency of hypercholesterolemia, elevated LDL-C, hypertriglyceridemia in FES were not significantly different to controls. Conclusions The results indicated that abnormal HDL-C might be an early-onset event in drug-naive FES of adolescents and young adults who are unlikely to have other cardiometabolic risks.