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Impact of olanzapine or risperidone treatment on insulin sensitivity in schizophrenia or schizoaffective disorder.

Authors :
Hardy TA
Henry RR
Forrester TD
Kryzhanovskaya LA
Campbell GM
Marks DM
Mudaliar S
Source :
Diabetes, obesity & metabolism [Diabetes Obes Metab] 2011 Aug; Vol. 13 (8), pp. 726-35.
Publication Year :
2011

Abstract

Aim: To assess changes in insulin sensitivity in non-diabetic adults with schizophrenia or schizoaffective disorder treated with olanzapine or risperidone.<br />Methods: One hundred and thirty patients were randomly assigned to 12 weeks double-blind treatment with olanzapine or risperidone. Insulin sensitivity was measured using a two-step euglycaemic, hyperinsulinaemic clamp procedure. Whole-body adiposity was measured using dual-energy X-ray absorptiometry. The primary endpoint was the within-group change from baseline in insulin sensitivity normalized to fat-free mass (M(ffm) /I) during the clamp procedure's low-insulin phase, using an analysis of covariance model including the covariate weight change.<br />Results: Forty-one olanzapine-treated and 33 risperidone-treated patients completed baseline and endpoint clamp measurements. Mean M(ffm) /I during the low-insulin phase declined 9.0% (p = 0.226) in olanzapine-treated patients and 13.2% (p = 0.047) in risperidone-treated patients (between-group difference p = 0.354). During the high-insulin phase, M(ffm) /I declined 10.4% (p = 0.036) in olanzapine-treated patients and 2.1% (p = 0.698) in risperidone-treated patients (between-group difference p = 0.664). Changes in M(ffm) /I correlated inversely with changes in body weight and adiposity, which were generally higher in olanzapine-treated patients. Significant within-group increases in fasting glucose, but not haemoglobin A1c (HbA1c), were observed during olanzapine treatment. The fasting glucose change was not correlated with M(ffm) /I changes.<br />Conclusions: Small, but statistically significant, decrements in insulin sensitivity were observed in olanzapine- and risperidone-treated patients at 1 of 2 insulin doses tested. Significant increases in fasting glucose and insulin and total fat mass were observed only in olanzapine-treated patients. Changes in insulin sensitivity correlated significantly with changes in weight or adiposity, but not with changes in glucose.<br /> (© 2011 Blackwell Publishing Ltd.)

Details

Language :
English
ISSN :
1463-1326
Volume :
13
Issue :
8
Database :
MEDLINE
Journal :
Diabetes, obesity & metabolism
Publication Type :
Academic Journal
Accession number :
21435142
Full Text :
https://doi.org/10.1111/j.1463-1326.2011.01398.x