A META-ANALYSIS OF ABNORMAL GLUCOSE METABOLISM IN FIRST-EPISODE DRUG-NAIVE SCHIZOPHRENIA

• Published in: Psychiatria Danubina Vol. 32; no. 1; pp. 46 - 54
• Main Authors: Yang, Wenjuan, Zheng, Lulu, Zheng, Bei, Zeng, Shen, Li, Jingjing, Liang, Bingqing, Zhu, Jun, Zhang, Meiling
• Format: Journal Article
• Language: English
• Published: Croatia Medicinska naklada 01.01.2020
• Subjects: Blood Glucose - metabolism; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - metabolism; drug-naïve; First-episode schizophrenia; Glucose - metabolism; Humans; Insulin - blood; Insulin - metabolism; Schizophrenia - blood; Schizophrenia - complications; Schizophrenia - drug therapy; Schizophrenia - metabolism
• ISSN: 0353-5053; 1849-0867
• DOI: 10.24869/psyd.2020.46

Patients with schizophrenia exhibit a higher mortality rate compared with the general population. This mortality has been attributed predominantly by the high risk of type 2 diabetes mellitus in the patients. We aimed to assess the inherent risk of glucose metabolism abnormalities in first-episode drug-naive schizophrenia. We searched English database (PubMed, EMBASE, MEDLINE, Cochrane Library databases) and Chinese database (Wan Fang Data, CBM disc, VIP, and CNKI) from their inception until Jul 2018 for case-control studies examining glucose metabolism abnormalities. Measurements, such as fasting plasma glucose levels, fasting plasma insulin levels, insulin resistance and HbA1c levels in first-episode antipsychotic-naive patients were used to test for prediabetes. Standardized/weighted mean differences and 95% confidence intervals were calculated and analyzed. 19 studies (13 in English and 6 in Chinese) consisting of 1065 patients and 873 controls were included. Fasting plasma glucose levels (95% CI; 0.02 to 0.29; P=0.03), 2 h plasma glucose levels after an OGTT (95% CI; 0.63 to 1.2; P<0.00001), fasting plasma insulin levels (95% CI; 0.33 to 0.73; P<0.00001), insulin resistance (95% CI; 0.29 to 0.6; P<0.00001) in patients with first-episode schizophrenia were significant elevated. There was no significant difference in HbA1c level (95% CI; -0.34 to 0.18; P=0.54) in patients with first-episode schizophrenia compared with controls. This meta-analysis showed that glucose metabolism was impaired in patients with first-episode schizophrenia. Higher quality studies with larger samples are warranted to confirm these findings.