LEVELS OF C- REACTIVE PROTEIN IN SCHIZOPHRENIA AND BIPOLAR DISORDER: CORRELATION WITH THE DURATION OF ANTIPSYCHOTICS TREATMENT AND METABOLIC SYNDROME

HERBST, LUIS; SAIDMAN, NORBERTO; CASSANELLI, MARTÍN; LEIDERMAN, E; CORTESI, SANTIAGO; GOLDCHLUK, ANÍBAL; SILVIA INES WIKINSKI

New York

Congreso; 167th Annual Meeting of the American Psychiatric Association; 2014

American Pshchiatric Association

NR3-002 LEVELS OF C- REACTIVE PROTEIN IN SCHIZOPHRENIA AND BIPOLAR DISORDER: CORRELATION WITH THE DURATION OF ANTIPSYCHOTICS TREATMENT AND METABOLIC SYNDROME Lead Author: Luis G. Herbst, M.D. Co-Author(s): Herbst L2 , Cassanelli M1, Leiderman E3, Goldchluk A2, Saidman N2, Cortesi S2, Wikinski S1,3,4. SUMMARY: Schizophrenia and bipolar disorder patients have a higher mortality compared with the general population. One of the main causes of this higher mortality in both diseases is the increase of cardiovascular risk factors, mainly the metabolic parameters. Altered inflammatory markers are also found in both conditions and have been associated with the pathophysiology of both diseases. Among those inflammatory factors, plasma levels of C-Reactive Protein (CRP) are increased.Higher levels of this protein associated with the metabolic syndrome increases cardiovascular risk. The aims of our study were to investigate: 1) whether prolonged treatment with antipsychotics reduces high levels of CRP, 2) if the abnormal levels of CRP correlates with metabolic abnormalities and 3) if metabolic syndrome is associated with high CRP levels increasing cardiovascular risk. Method:We recruited 137 outpatients treated with antipsychotics who were consecutively assisted in the Outpatient Unit. Patients gave their written consent. The diagnosis of schizophrenia and bipolar disorder was done with the MINI Structured Interview. Demographic data:age, sex and education level, treatment schedules received, current medication, doses used, concomitant drugs. Metabolic parameters measured: body weight, height, waist-hip circumference and blood pressure. Once this procedure was completed, participants were assessed the following week with 12 hours of fasting to obtain a blood sample.Biochemical parameters quantified: fasting blood glucose, insulinemia, total cholesterol and HDL, triglycerides, CRP. Results:56.3 % of men and 35.5 % of women had at least three criteria for diagnosis of metabolic syndrome. The average treatment time was 18,5 ± 8,9 years. The values of CRP averaged 4.5 mg/l. 42 % of men and 23.5 % of women had CRP values between 1 y 3 mg/l which means cardiovascular risk, 41.1 % of men and 70.6 % of women showed values higher than 3 which means high cardiovascular risk. The CRP showed no significant correlation with duration of treatment (rs = 0. 18; p =ns). The CRP showed statistical significant correlation with blood glucose (rs = 0.19; p = 0.03) and HDL (rs = -0, 27; p = 0.002) and a trend to significance with triglycerides (rs =0.17; p = 0.05) and systolic pressure (rs =0.17; p = 0.05).Conclusions: All of our sample showed elevated CRP, 83.1 % of the patients presented risk values or high cardiovascular risk. As the duration of treatment with antipsychotics did not change the inflammatory factor, we can rule out a direct effect of antipsychotic drugs on it. However, a considerable number of patients presented high CRP associated with metabolic syndrome factors showing the association between inflammatory factors and a probable higher cardiovascular risk. Future studies should clarify whether the correlation between CRP, HDL and glucose is a characteristic of both psychiatric diseases or is induced by prolonged use of antipsychotics .