Ghrelin and leptin levels in schizophrenic patients treated with antipsychotic monotherapy.

摘要

The prevalence of weight gain (WG) and obesity among patients with schizophrenia has become more pronounced with increasing use of atypical antipsychotics (AAPs).Changes in leptin, an anorexigenic adipocyte-derived signal molecule, and ghrelin, a gastric appetite-stimulating peptide, concentrations during antipsychotic treatment support the notion that the 2 hormones are possibly involved in the weight change of psychotic patients. Indeed, high leptin and low ghrelin levels seem associated with metabolic disturbances including metabolic syndrome (MS). However, it is not yet fully understood if the circulating leptin and ghrelin (which is present under 2 forms in blood: an acylated and a desacylated one) concentrations reflect a direct effect of AAPs drugs or if they are secondary to the AAP-induced WG. In a recent study of exposure to AAPs in healthy subjects, a significant decrease in ghrelin area under the curve was reported for olanzapine in comparison with risperidone but not between risperidone and placebo or olanzapine and placebo. Several studies of schizophrenic patients treated with AAPs, mainly clozapine and olanzapine (see works by Sentissi et al and Jin et al for review), highlighted that serum leptin levels increase significantly from baseline, as soon as a few hours after the beginning of the treatment, and remain somehow elevated up to several months. In contrast, risperidone and conventional neuroleptics seemed ineffective on leptin levels.