Hyperhomocysteinemia in Treatment with Atypical Antipsychotics is Independent of Metabolic Syndrome

Abstract

Strong association between homocysteine (Hcy) and metabolic syndrome (MetS) is documented in individuals with schizophrenia and it is suggested that alterations in Hcy levels might be secondary to metabolic changes induced by atypical antipsychotics (AA). Serum paraoxonase (PON-1) activity, which is negatively affected by increased Hcy concentrations are lower in schizophrenia, and this may impact the development of metabolic side effects. Forty-five subjects with schizophrenia and 43 healthy volunteers, matched according to age, gender, smoking habits, and MetS predictors, were enrolled in this study to examine how Hcy level, PON-1 activity, and MetS indicators influence each other in schizophrenic individuals on AA treatment. Serum Hcy concentrations were significantly higher (15 ± 8 μmol/L vs 12 ± 3 μmol/L), and PON activity tended to be impaired (182±82 U/L vs 216 ± 110 U/L) in schizophrenia. Serum Hcy concentrations were not different between subjects with and without metabolic syndrome in study (14±4 μmol/L and 16±9 μmol/L) and control groups (12±3 μmol/L and 13±7 μmol/L), respectively. Similarly, PON and aryl esterase (AE) activities were not different between subjects with and without metabolic syndrome in study (PON: 185±100 U/L and 181±76 U/L; AE: 84±34 kU/L and 89±20 kU/L) and control (PON: 215±111 U/L and 216±113 U/L; AE: 83±27 kU/L and 88±33 kU/L) groups, respectively. . Hcy levels and MetS predictors were not statistically correlated. Results indicate that schizophrenic subjects on AA treatment have increased levels of Hcy compared to healthy controls and this is not influenced by the presence of MetS.

Keywords

• Atypical antipsychotics
• schizophrenia
• homocysteine
• metabolic syndrome

Atipik Antipsikotiklerle Tedavi Sürecinde Görülen Hiperhomosisteinemi Metabolik Sendromdan Bağımsızdır

Öz

Şizofreni olgularında homosistein (Hcy) ve metabolik sendrom (MetS) arasında güçlü ilişki olduğu bildirilmiş ve Hcy düzeylerindeki artışın atipik antipsikotikler (AA) ile uyarılan metabolik değişikliklere bağlı gelişebileceği düşünülmüştür. Artmış Hcy düzeylerinin negatif yönde etkilediği serum paraoksanaz (PON-1) aktivitesi, şizofrenili bireylerde düşük bulunmaktadır ve bu durumun metabolik yan etkilere neden olabileceği öne sürülmektedir. Bu çalışmada, AA tedavisi alan şizofreni kişilerde Hcy düzeyleri, PON-1 activitesi ve MetS indikatörlerinin birbirlerinden nasıl etkilendiğini incelemek üzere yaş, cinsiyet, sigara alışkanlığı ve MetS göstergelerine göre eşleştirilmiş 45 şizofreni olgusu ve 43 sağlıklı kontrol ile çalışıldı. Şizofreni olgularında serum Hcy düzeyleri anlamlı olarak yüksek (15 ± 8 μmol/L ve 12 ± 3 μmol/L) bulunurken, PON aktivitesinde (182±82 U/L ve 216 ± 110 U/L) azalma eğilimi olduğu gözlendi. Metabolik sendromu olan ve olmayan bireylerin Hcy konsantrasyonları arasında fark yoktu (Şizofreni grubunda sırasıyla, 14±4 μmol/L ve 16±9 μmol/L; Kontrol grubunda sırasıyla, 12±3 μmol/L and 13±7 μmol/L). Benzer şekilde, PON ve aril esteraz (AE) aktiviteleri değerlendirildiğinde metabolik sendromu olan ve olmayan şizofreni grubundaki bireylerin (PON: sırasıyla, 185±100 U/L ve 181±76 U/L; AE: sırasıyla, 84±34 kU/L ve 89±20 kU/L) ve kontrol grubundaki bireylerin (PON: sırasıyla, 215±111 U/L ve 216±113 U/L; AE: sırasıyla, 83±27 kU/L ve 88±33 kU/L) enzim aktivitelerinde fark bulunmadı.Hcy düzeyleri ile MetS göstergeleri arasında istatistiksel ilişki saptanmadı. Sonuçlara göre, AA tedavisi alan şizofreni olgularında Hcy düzeyleri sağlıklı kontrollere göre daha yüksektir ve bu durum MetS varlığından etkilenmemektedir.

Anahtar Kelimeler

• Atipik antipsikotikler
• Şizofreni
• Homosistein
• Metabolik sendrom
• Paraoksonaz

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