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Aminotransferase levels as a prospective predictor for the development of metabolic syndrome in patients with schizophrenia

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Abstract

Rationale

Increased levels of alanine aminotransferase (ALT) are a biomarker for metabolic syndrome (MetS), but this relationship remains unproven in patients with schizophrenia.

Objective

We assessed the relationship between aminotransferase levels and MetS in patients with schizophrenia.

Method

This pooled analysis from two open-label prospective studies included 342 patients with schizophrenia who did not meet criteria for MetS at baseline. The development of MetS was assessed at weeks 12 and 24.

Results

MetS developed in 19.1 % of patients during the 24-week follow-up period. ALT levels were significantly associated with incident MetS: for each sex-specific standard deviation increase in log ALT, the odds ratio (OR) of MetS was 1.357 (p = .006) after adjusting for age, sex, duration of illness, smoking, and previous use of antipsychotics. This result remained significant after adjusting for interim weight changes. Compared with patients in the lowest quartile, the OR of MetS in those in the highest quartile within the normal range of ALT levels was 4.276 (p = .024). However, this association was significant only in male patients. Using a cutoff value of 23.0 U/L, sensitivity and specificity were 70.6 and 68.3 %, respectively, in male patients whose ALT levels were in the normal range.

Conclusions

A prospective association between ALT levels and MetS highlights the value of ALT levels, even mild ALT elevations within the normal range, as a predictor of the MetS risk in male patients. Baseline liver function tests and monitoring should be obtained during antipsychotic treatment to identify the risk for MetS.

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Acknowledgments

The original two study included in this pooled analysis was supported by a grant from Janssen Korea Co. Ltd. However, Janssen Korea had no involvement in the design of this analysis or interpretation of the data, writing of the report, or the decision to submit the paper for publication.

Conflict of interest

Dr. Yong Min Ahn received research grants and served as a lecturer for AstraZeneca, GlaxoSmithKline, Janssen, Lilly, Lundbeck, Otsuka, Pfizer, and Servier. Dr Jin Sang Yoon has received grant supports from Janssen, Lundbeck, and Otsuka and served as a lecturer for Janssen, Lundbeck, Otsuka, Pfizer, and GlaxoSmithKline. Dr Yong Sik Kim has received grants, research support, and/or honoraria from Novartis, Janssen, Eli Lilly, Pfizer, Sanofi-Aventis, Otsuka, AstraZeneca, Organon, GlaxoSmithKline, and Servier. All other authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea

    Eun Young Kim & Yong Min Ahn

  2. Medical Research Institute, Seoul National University, Seoul, Republic of Korea

    Se Hyun Kim

  3. Department of Neuropsychiatry, Dongguk University Medical School, Dongguk University International Hospital, Goyang, Republic of Korea

    Nam Young Lee & Yong Sik Kim

  4. Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea

    Jin Sang Yoon

  5. Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea

    Chul Eung Kim

  6. Institute of Human Behavioral Medicine, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, Republic of Korea

    Yong Min Ahn

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  1. Eun Young Kim
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Correspondence to Yong Min Ahn.

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Kim, E.Y., Kim, S.H., Lee, N.Y. et al. Aminotransferase levels as a prospective predictor for the development of metabolic syndrome in patients with schizophrenia. Psychopharmacology 231, 4479–4487 (2014). https://doi.org/10.1007/s00213-014-3601-7

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  • DOI: https://doi.org/10.1007/s00213-014-3601-7

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