PMID- 35280179
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220316
IS  - 1664-0640 (Print)
IS  - 1664-0640 (Electronic)
IS  - 1664-0640 (Linking)
VI  - 13
DP  - 2022
TI  - Antipsychotic-Related Risks of Type 2 Diabetes Mellitus in Enrollees With 
      Schizophrenia in the National Basic Public Health Service Program in Hunan 
      Province, China.
PG  - 754775
LID - 10.3389/fpsyt.2022.754775 [doi]
LID - 754775
AB  - BACKGROUND: Antipsychotics contribute to the development of type 2 diabetes 
      mellitus (T2DM) in individuals with schizophrenia. However, the extent of the 
      relationship between antipsychotic use and T2DM varies in different settings, and 
      the magnitude of the drug-specific effects fluctuates widely. This study aimed to 
      explore the association of T2DM with antipsychotic use among enrollees with 
      schizophrenia in China's National Basic Public Health Service Program (NBPHSP) 
      and the drug-specific relationship with T2DM among patients receiving 
      antipsychotic monotherapy. METHODS: We recruited diabetes-free patients with 
      schizophrenia who were enrolled in the NBPHSP of Hunan Province from October 2009 
      to December 2018. The participants were classified into the following three 
      groups: regular antipsychotic use, intermittent antipsychotic use, and 
      antipsychotic-free groups. The patients were followed up until they received a 
      T2DM diagnosis or until April 2019. Cox regression models were constructed to 
      calculate the overall and drug-specific hazard ratios (HRs) to determine the 
      antipsychotic-T2DM relationship. Interactive and subgroup analyses were performed 
      to assess the heterogeneity of the effects across subgroups. RESULTS: A total of 
      122,064 NBPHSP enrollees with schizophrenia were followed up for 1,507,829 
      cumulative person-years, and 2,313 (1.89%) patients developed T2DM. Patients who 
      regularly and intermittently used antipsychotics had 117% (HR: 2.17, 95% CI: 
      1.83-2.57) and 53% (HR: 1.53, 95% CI: 1.23-1.90) higher risks of developing T2DM 
      than antipsychotic-free patients, respectively. Regarding monotherapy, the T2DM 
      risk increased by 66, 80, 62, and 64% after the regular use of clozapine, 
      risperidone, chlorpromazine, and perphenazine, respectively. In addition, the 
      antipsychotic-related risk of T2DM decreased as the patient's baseline body mass 
      index, and baseline fasting plasma glucose level, as well as the dietary 
      proportion of animal products, increased. CONCLUSION: Antipsychotics, especially 
      clozapine, risperidone, chlorpromazine, and perphenazine, increased the T2DM risk 
      among NBPHSP enrollees with schizophrenia. Mental health officers should 
      accurately identify enrollees at a high risk of T2DM and take appropriate 
      preventive measures to reduce the incidence of T2DM among patients with 
      schizophrenia.
CI  - Copyright (c) 2022 Ouyang, He, Cheng, Zhou, Xiao and Fang.
FAU - Ouyang, Feiyun
AU  - Ouyang F
AD  - Department of Social Medicine and Health Management, Xiangya School of Public 
      Health, Central South University, Changsha, China.
FAU - He, Jun
AU  - He J
AD  - Department of Social Medicine and Health Management, Xiangya School of Public 
      Health, Central South University, Changsha, China.
FAU - Cheng, Xunjie
AU  - Cheng X
AD  - Department of Geriatric Medicine, Xiangya Hospital, Central South University, 
      Changsha, China.
FAU - Zhou, Wei
AU  - Zhou W
AD  - Research Center for Public Health and Social Security, School of Public 
      Administration, Hunan University, Changsha, China.
FAU - Xiao, Shuiyuan
AU  - Xiao S
AD  - Department of Social Medicine and Health Management, Xiangya School of Public 
      Health, Central South University, Changsha, China.
FAU - Fang, Junqun
AU  - Fang J
AD  - Department of Health Management, Maternal and Child Health Hospital of Hunan 
      Province, Changsha, China.
LA  - eng
PT  - Journal Article
DEP - 20220224
PL  - Switzerland
TA  - Front Psychiatry
JT  - Frontiers in psychiatry
JID - 101545006
PMC - PMC8909132
OTO - NOTNLM
OT  - antipsychotic
OT  - monotherapy
OT  - polytherapy
OT  - schizophrenia
OT  - type 2 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/03/15 06:00
MHDA- 2022/03/15 06:01
PMCR- 2022/02/24
CRDT- 2022/03/14 05:07
PHST- 2021/08/07 00:00 [received]
PHST- 2022/01/28 00:00 [accepted]
PHST- 2022/03/14 05:07 [entrez]
PHST- 2022/03/15 06:00 [pubmed]
PHST- 2022/03/15 06:01 [medline]
PHST- 2022/02/24 00:00 [pmc-release]
AID - 10.3389/fpsyt.2022.754775 [doi]
PST - epublish
SO  - Front Psychiatry. 2022 Feb 24;13:754775. doi: 10.3389/fpsyt.2022.754775. 
      eCollection 2022.