The Antiatherogenic Properties of HDL in Psychiatric Patients With and Without Antipsychotic Therapy
Recruitment status was: Recruiting
Among individuals with schizophrenia, there is an increased prevalence of obesity, dyslipidemia ,diabetes mellitus and related conditions such as cardiovascular disease. People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. Number of epidemiological studies of patients with schizophrenia have documented a higher incidence of cardiovascular disease than in the general population, and patients with schizophrenia may be at an elevated risk for cardiovascular disease even in the absence of antipsychotic treatment.
Affinity for the H1 receptor is most closely linked to increased weight gain, although affinity for D2, 5-HT1A, 5-HT2C and a2-receptors may also be involved. Drug affinity for the H1, M3 and 5-HT2C receptors is correlated with an increased risk of diabetes.
High-density lipoprotein cholesterol (HDL-C) concentration in the blood is independently and inversely associated with an increased risk of cardiovascular disease(CVD). However many patients with 'normal' or even 'elevated' plasma HDL experience clinical events. HDL may not always be atheroprotective and in some conditions, it paradoxically enhances the process of atherosclerosis. In addition to its role in reverse cholesterol transport, HDL shows many other protective properties towards atherosclerosis. HDL inhibits the chemotaxis of monocytes , prevents endothelial dysfunction and apoptosis, prohibit slow-density lipoprotein (LDL ) oxidation, and stimulates the proliferation of endothelial cells and smooth muscle cells. These anti-inﬂammatory, antioxidative, antiaggregatory, anti-coagulant, and pro-ﬁbrinolytic activities are exerted by different components of HDL
Aim of the study:
To investigate the functional properties of HDL in psychiatric patients before and during antipsychotic therapy.
Patients and methods:
The blood will be drawn at baseline before the initiation of antipsychotic drugs and 2 months under the antipsychotic treatment.
Full lipid profile including triglycerides, LDL-C, Total cholesterol, HDL-cholesterol, apo AI, apoAII and apoB100.
Serum Paraoxanase Activity
LDL oxidation and resistance to oxidation (measured by conjugated diens formation during incubation in the presence of copper).
HDL composition: total and unesterified cholesterol, triglycerides and phospholipids, TBARS content before and after exposure to AAPH as a major indicator of oxidative stress, PON activity using phenylacetate as a substrate, apoA1and PAF.
Serum parameters e.g. Diacyl glycerol acyltransferase activity, free ApoA1 and LCAT activity.
3 [H]-Cholesterol efflux will be measured by incubating J744 macrophages with serum. Radioactivity will measured by β counter in the cell lysate and the medium.
One-way AVOVA and Student's t-test for paired samples will be used for comparison of multiple groups and paired samples, respectively. p<0.05 will be considered significant.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||The Antiatherogenic Properties of HDL in Psychiatric Patients With and Without Antipsychotic Therapy|
|Study Start Date:||November 2010|
|Estimated Primary Completion Date:||December 2014 (Final data collection date for primary outcome measure)|
20 in patients and outpatients with schizophrenia, schizoaffective and bipolar disorder based on psychiatrist diagnostic evaluation using DSM-IV criteria, before and at least two months after antipsychotic therapy will be enrolled.
Ten healthy volunteers will be checked as controls:
Employee from the hospital staff with no metabolic disease (Diabetes mellitus, hypertension or dyslipidemia) and non-smokers.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01215383
|Ziv Medical Center (Government Hospital)|
|Safed, Israel, 13110|