Professional paper - Review paper
Etiopathogenesis of metabolic syndrome in schizophrenia – recent findings

Nadalin, Sergej; Gudeljević, Marija; Severec, Josipa; Rebić, Jelena; Kapović, Miljenko; Buretić-Tomljanović, Alena (2017)
Metadata
Language Croatian
Title (Croatian)Etiopatogeneza metaboličkog sindroma u shizofreniji – najnovije spoznaje
Title (English)Etiopathogenesis of metabolic syndrome in schizophrenia – recent findings
AuthorNadalin, Sergej
Gudeljević, Marija
Severec, Josipa
Rebić, Jelena
Kapović, Miljenko
Buretić-Tomljanović, Alena
Abstract (Croatian)
Uzrok polovice do dvije trećine smrtnih ishoda pacijenata sa shizofrenijom pripisuje se kardiovaskularnim bolestima. Smatra se da visoka učestalost metaboličkog sindroma najviše povećava rizik za nastanak kardiovaskularnih oboljenja u shizofreniji. Iako je metabolički sindrom jedan od vodećih uzroka morbiditeta i mortaliteta u pacijenata sa shizofrenijom, do prije petnaestak godina istraživanje etiologije metaboličkog sindroma u shizofreniji nije predstavljalo veći znanstveni interes. Novije spoznaje ukazuju na mogućnost da bi pojačano stanje upalnog odgovora u organizmu moglo predstavljati zajedničku etiopatogenetsku podlogu u nastanku metaboličkog sindroma i shizofrenije. Primjerice, značajno povišena koncentracija proupalnih citokina te C reaktivnog proteina uočena je u pacijenata sa shizofrenijom koji nisu uzimali antipsihotične lijekove ili su ih uzimali u vrlo malim dozama, a zamijećeno je i da uzimanje inhibitora ciklooksigeneze-2, uz antipsihotičnu terapiju, može ublažiti težinu kliničkih simptoma i kognitivnih deficita u oboljelih. U ovom preglednom radu iznesene su najnovije spoznaje o ulozi okolišnih i genetičkih čimbenika u etiopatogenezi metaboličkog sindroma u shizofreniji. Mnogi mehanizmi kojima bi okolišni čimbenici, poput nezdrave prehrane i pušenja, mogli pridonijeti nastanku metaboličkog sindroma u shizofreniji ne razlikuju se značajno u odnosu na opću populaciju. Ipak, uzimanje antipsihotičnih lijekova, posebice tzv. atipičnih antipsihotika, te njihova interakcija s okolišnim čimbenicima, kao i genetičkim čimbenicima podložnosti, dodatno pridonose heterogenosti etiopatogeneze metaboličkog sindroma u shizofreniji, ali i otežavaju adekvatan terapijski pristup. Budući da su dosadašnja istraživanja uglavnom bila usredotočena na moguću poveznicu antipsihotičnih lijekova i metaboličkih abnormalnosti u oboljelih, detaljnije su razmotrene značajke nezdrave prehrane i ovisnosti o pušenju te njihova moguća povezanost s metaboličkim sindromom.
Abstract (English)
The etiology of one half to two-thirds of deaths among patients with schizophrenia could be attributed to cardiovascular diseases. It is believed that high prevalence of metabolic syndrome mostly contributes to the risk of cardiovascular diseases in schizophrenia. Although the metabolic syndrome is among the leading causes of morbidity and mortality among patients with schizophrenia, fifteen years ago studies investigating the etiology of the metabolic syndrome among patients with schizophrenia were not a part of scientific interest. Recent findings indicate the possibility that increased state of inflammatory response in the organism may underlie the etiopathogenesis of both schizophrenia and metabolic syndrome. For instance, significantly increased levels of proinflammatory cytokines and C reactive protein have been observed in schizophrenia patients with minimal or no exposure to antipsychotics and it has also been revealed that cyclooxygenase-2 inhibitor drugs add-on treatment to the antipsychotic therapy may lead to decrease in clinical symptom severity and alleviate cognitive deficits in the patient group. In this review we aim to provide an update on genetics and environmental factors in the etiopathogenesis of metabolic syndrome in schizophrenia. Numerous mechanisms by which the environmental factors such as unhealthy diet pattern and smoking could contribute to the etiology of the metabolic syndrome in schizophrenia do not differ significantly compared to a healthy population. However, treatment with antipsychotic medications, particularly with atypical antipsychotics, as well as interaction between antipsychotic drugs and environmental and genetic risk factors may additionally lead to heterogeneity of the etiopathogenesis of metabolic syndrome in schizophrenia as well as to complicate treatment approach. Since previous studies have been mostly focused on plausible associations between antipsychotic medications and metabolic abnormalities, we provided a more detailed characteristic of unhealthy diet among schizophrenia patients and its plausible relation to metabolic syndrome. Furthermore, more deeply have been discussed the possible associations between nicotine dependence and metabolic syndrome.
Keywords (Croatian)antipsihotični lijekovi genetika prehrana pušenje shizofrenija
Keywords (English)antipsychotic agents diet genetics schizophrenia smoking
Publication typeprofessional paper - review paper
Publication statuspublished
Peer reviewpeer review
Journal titleMedicina Fluminensis : Medicina Fluminensis
Numbering2017, Vol. 53, No. 1, pp 27-42
ISSN0025-7729
Datepublication: 01.03.2017.
DOI identifier10.21860/medflum2017_173383
Article URLhttp://hrcak.srce.hr/173383
Scientific fieldBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Psychiatry
Scientific fieldBIOMEDICINE AND HEALTHCARE
Basic Medical Sciences
Human Genetics, Genomics and Proteomics
InstitutionUniversity of Rijeka, Faculty of Medicine
(Department of Biology and Medical Genetics)
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:125071