Influence of resting energy expenditure on weight gain in adolescents taking second-generation antipsychotics |
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Authors: | Cuerda Cristina Merchan-Naranjo Jessica Velasco Cristina Gutierrez Alberto Leiva Marta de Castro Maria J Parellada Mara Giráldez Marisa Bretón Irene Camblor Miguel García-Peris Pilar Dulín Elena Sanz Inmaculada Desco Manuel Arango Celso |
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Affiliation: | aUnidad de Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, Spain;bUnidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain;cBiochemistry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain;dUnidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM Madrid, Spain |
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Abstract: |
Background & aims: Weight gain is an undesirable side effect of second-generation antipsychotics (SGAs). We performed this study to examine the influence of SGAs on resting energy expenditure (REE) and the relationship of REE to weight gain in adolescent patients.MethodsAntipsychotic-naïve or quasi-naïve (<72 h of exposure to antipsychotics) adolescent patients taking olanzapine, quetiapine, or risperidone in monotherapy were followed up for one year. We performed a prospective study (baseline, 1, 3, 6, and 12 months after treatment) based on anthropometric measurements, bioelectrical impedance analysis, and indirect calorimetry (Deltatrac™ II MBM-200) to measure REE. We also analyzed metabolic and hormonal data and adiponectin concentrations.ResultsForty-six out of the 54 patients that started treatment attended at least 2 visits, and 16 completed 1 year of follow-up. Patients gained 10.8 ± 6.2 kg (60% in the form of fat mass) and increased their waist circumference by 11.1 ± 5.0 cm after 1 year of treatment. The REE/kg body mass ratio decreased (p = 0.027), and the REE/percentage fat-free mass (FFM) ratio increased (p = 0.007) following the fall in the percentage of FFM during treatment. Weight increase was significantly correlated with the REE/percentage FFM ratio at all the visits (1–3–6–12 months) (r = 0.69, p = 0.004 at 12 months).ConclusionsSGAs seem to induce a hypometabolic state (reflected as decreased REE/kg body mass and increased REE/percentage FFM). This could explain, at least in part, the changes in weight and body composition observed in these patients. |
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Keywords: | Antipsychotics Resting energy expenditure Weight gain Metabolic side effects Adiponectin Adolescents |
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