Low-grade inflammation in first-episode psychosis is determined by increased waist circumference. (December 2018)

• Record Type: Journal Article
• Authors: Keinänen, Jaakko; Suvisaari, Jaana; Reinikainen, Jaakko; Kieseppä, Tuula; Lindgren, Maija; Mäntylä, Teemu; Rikandi, Eva; Sundvall, Jouko; Torniainen-Holm, Minna; Mantere, Outi
• Is Part Of: Psychiatry research. Volume 270(2018)
• Page Start: 547
• Page End: 553
• Publication Date: 2018-12
• Subjects: Early psychosis -- Chronic inflammation -- C-reactive protein -- Abdominal obesity -- Weight gain -- Cardiovascular risk; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.10.022
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: In FEP, anthropometric measures and hs-CRP were similar to controls at baseline. Total cholesterol, LDL, and triglycerides were higher from treatment onset. Insulin resistance was present at treatment onset with no change in follow-up. Visceral obesity resulted in low-grade inflammation during the first treatment year. Obesity-associated low-grade inflammation adds to the cardiovascular risk in FEP. Abstract: Psychosis is associated with low-grade inflammation as measured by high-sensitivity C-reactive protein (hs-CRP), a risk factor for cardiovascular events and mortality in the general population. We investigated the relationship between hs-CRP and anthropometric and metabolic changes in first-episode psychosis (FEP) during the first treatment year. We recruited 95 FEP patients and 62 controls, and measured longitudinal changes in hs-CRP, weight, waist circumference, insulin resistance, and lipids. We used linear mixed models to analyze the longitudinal relationship between hs-CRP and clinical, anthropometric and metabolic measures. At baseline, patients with FEP had higher levels of insulin resistance, total and low-density lipoprotein cholesterol, apolipoprotein B, and triglycerides. Baseline weight, waist circumference, hs-CRP, fasting glucose, and high-density lipoprotein cholesterol were similar between patients and controls. Marked increases in anthropometric measures and hs-CRP were observed in FEP during the 12-month follow-up. However, glucose and lipid parameters did not change significantly. In the mixed models, waist circumference and female sex were significant predictors of hs-CRP levels in FEP. Prevention of the early development of abdominal obesity in FEP is crucial, as abdominal obesity is accompanied by chronic low-grade inflammation, which increases further the cardiovascular risk in this vulnerable population.