Impact of risperidone on leptin and insulin in children and adolescents with autistic spectrum disorders

• Published in: Clinical biochemistry Vol. 50; no. 12; pp. 678 - 685
• Main Authors: Srisawasdi, Pornpen, Vanwong, Natchaya, Hongkaew, Yaowaluck, Puangpetch, Apichaya, Vanavanan, Somlak, Intachak, Boontarika, Ngamsamut, Nattawat, Limsila, Penkhae, Sukasem, Chonlaphat, Kroll, Martin H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2017
• Subjects: Adiponectin - blood; Adolescent; Antipsychotic Agents - administration & dosage; Antipsychotic Agents - adverse effects; Autistic Disorder - blood; Autistic Disorder - drug therapy; Autistic Disorder - physiopathology; Autistic spectrum disorders; Blood Glucose - metabolism; C-Reactive Protein - metabolism; Child; Child, Preschool; Children; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - chemically induced; Diabetes Mellitus, Type 2 - prevention & control; Female; Humans; Hydrocortisone - blood; Insulin - blood; Insulin Resistance; Leptin - agonists; Leptin - blood; Male; Metabolic risk factors; Monitoring, Physiologic; Prolactin - blood; Risperidone; Risperidone - administration & dosage; Risperidone - adverse effects; Autistic spectrum disorders; Metabolic risk factors; Diabetes; Children; Risperidone; Adolescent
• ISSN: 0009-9120; 1873-2933
• DOI: 10.1016/j.clinbiochem.2017.02.003

To evaluate the influence of dose and duration of risperidone treatment on cardiovascular and diabetes risk biomarkers in children and adolescents with autistic spectrum disorders (ASDs). In this cross-sectional analysis, a total of 168 ASDs patients (89% male) treated with a risperidone-based regimen for ≥12months were included. Blood samples were analyzed for glucose and lipid metabolic markers, adiponectin, leptin, prolactin, cortisol and high sensitive C-reactive protein. The mean concentrations of glucose, insulin, prolactin and leptin and HOMA-IR significantly rose with risperidone dosage (all P<0.025), but those of adiponectin and cortisol did not. Using regression analysis, insulin, leptin, prolactin and glucose concentrations and HOMA-IR show significant association with dosage. None of the markers except adiponectin showed dependence on duration of treatment. However, insulin and leptin concentrations and HOMA-IR clearly increased with increasing both dosage and duration. Dosage and duration of treatment had minimal effect on standard lipid profile and lipoprotein subclasses. Risperidone treatment disturbed glucose homeostasis and endocrine regulation (particularly leptin) in children and adolescents with ASDs, in a dose- and duration-dependent manner, being suggestive of leptin and insulin resistance mechanisms. Metabolic adverse effects, especially development of type 2 diabetes mellitus should be closely monitored, particularly in individuals receiving high doses and/or long-term risperidone treatment. •Risperidone treatment disturbed glucose homeostasis and endocrine regulation.•Risperidone may directly induce insulin and leptin resistance.•These effects are related to dose and duration of treatment.•Enhancement of leptin and insulin actions could reduce the risk of metabolic complications.