S19. evidence of the lipid paradox in psychosis: a meta-analysis of cholesterol and triglyceride levels in first episode psychosis

This study set out to clarify the lipid status of antipsychotic naive/minimall y treated FEP, testing the hypothesis that if psychosis is deemed to be an inflammatory condition, then a serological metabolic signature characterized by reduced total and LDL cholesterol should be observed.MethodsA meta-analysis of studies examining lipid parameters in individuals with FEP and no or minimal antipsychotic exposure versus a healthy control group was performed. Studies reported fasting total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and leptin levels.ResultsOf 2070 citations retrieved, 20 case –control studies met inclusion criteria including 1167 patients and 1184 controls. Total cholesterol and LDL cholesterol levels were significantly decreased in patients compared with controls, corresponding to an absolute reduction of 0.26 mmol/L (p = 0.005) and 0.15 mmol/L (p = 0.001) respectivel y. These findings remained in BMI-matched sensitivity analyses. Triglyceride levels were significantly increased in the patient group, corresponding to an absolute increase of 0.08 mmol/L (p = 0.02). However, HDL cholesterol and leptin levels were not altered in patients compared with controls.DiscussionTotal and LDL cholesterol levels are reduced in FEP, findings which persist in BMI-matched sensitivity analyses. This metabolic signature, combined with elevated insulin resistance that we have previously demonstrated in FEP, mi...
Source: Schizophrenia Bulletin - Category: Psychiatry Source Type: research