Association of Adiponectin and Metabolic Syndrome among Patients Taking Atypical Antipsychotics for Schizophrenia: A Cohort Study

introduction: Adiponectin, an adipocyte-derived hormone controlling lipid and carbohydrate metabolism, has been suggested to be a biomarker for metabolic syndrome in the general population. This study investigated the association between adiponectin levels and metabolic syndrome in patients treated with atypical antipsychotics. Methods: Anthropometric and metabolic parameters and serum adiponectin levels were assessed in hospitalized patients with schizophrenia who had used the same atypical antipsychotic for at least 3 months. Retrospective reviews of the patients ' medical records were conducted to obtain demographic data and pretreatment characteristics. Results: The study included 567 schizophrenia patients treated with clozapme (n = 231 olanzapine (n = 94) and risperidone (n = 242), for an average of 45.8 +/- 27.8 months. The prevalence of metabolic syndrome among all subjects was 23.8%. The clozapine group had a higher prevalence of metabolic syndrome (28.7%) than did the olanzapine (24.2%) and risperidone groups (19.5%) (P=0.039), and the clozapine group had lower levels of adiponectin (8.46 +/- 6.02 mg/mL) than did the olanzapine (10.26 +/- 4.9 mg/mL) and risperidone groups (10. 69 +/- 7.43 mg/mL) (P=0.001). Adiponectin level was negatively correlated with body mass index (BMI) increase after initiation of antipsychotic treatment. Cross-sectional regression analysis showed that age (OR,= 1.042 , P=0.001), BMI (OR=1.404, P<0.0001), and adiponectin level (OR=0.862, P<0 .0001) were significant factors in the presence of metabolic syndrome. Significant predictors of metabolic syndrome were age at initiation of antipsychotic treatment (OR= 1.04, P = .007), BMI at initiation of antipsychotic treatment (OR=1.44, P<0.0001), BMI increase after initiation of antipsychotic treatment (OR =1.40, P<0.0001), and adiponectin level ( OR=0.86,P