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Dietary saturated fat intake and glucose metabolism impairments in nondiabetic, nonobese patients with schizophrenia on clozapine or risperidone

David C. Henderson, MD

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USA

Bikash Sharma, MBBS

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USA

Xiaoduo Fan, MD, MS

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USA

Christina P. Borba, MPH

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USA

Paul M. Copeland, MD

Harvard Medical School, Boston, MA, USA

Oliver Freudenreich, MD

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USA

Corinne Cather, PhD

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USA

A. Eden Evins, MD

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USA

Donald C. Goff, MD

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USA

BACKGROUND: High dietary saturated fat (SF) intake is strongly linked to metabolic disturbances. The goal of this study was to understand the relationship between clozapine and risperidone with glucose and lipid metabolism and dietary fat intake in patients with schizophrenia.

METHODS: Thirty-one clozapine-treated patients and 15 risperidone-treated patients were assessed using a 4-day dietary record, an IV glucose tolerance test, and lipid profiles.

RESULTS: Clozapine-treated patients consumed a significantly higher percentage of SF than did risperidone-treated patients (13.7% ± 3.4% vs 10.6% ± 3.0% of total energy; P = .007). Compared with the risperidone group, the clozapine group also had a significantly higher percentage of total fat in their diet (36% ± 6.7% vs 30.9% ± 5.7 % of total energy; P = .007). Similarly, the clozapine group had a significant impairment in insulin sensitivity index (SI), glucose effectiveness (SG), and disposition index (DI) compared with the risperidone group (P < .05). Pearson correlation analysis of both groups showed that dietary SF was significantly correlated with impairment in glucose homeostasis (SG: r = –0.43; P = .004; DI: r = –0.35; P = .02).

CONCLUSION: Abnormal glucose homeostasis in atypical clozapine-treated patients with schizophrenia may be associated with or aggravated by high dietary SF consumption.

KEYWORDS: schizophrenia, clozapine, risperidone, insulin resistance, saturated fat

ANNALS OF CLINICAL PSYCHIATRY 2010;22(1):33–42

CORRESPONDENCE: David C. Henderson, MD, Freedom Trail Clinic, 25 Staniford Street, Boston, MA 02114 USA E-MAIL: dchenderson@partners.org
Annals of Clinical Psychiatry ©2010 American Academy of Clinical Psychiatrists

 
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