Impact of low-dose quetiapine-use on glycosylated hemoglobin, triglyceride and cholesterol levels

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2022-10-25 DOI:10.1111/acps.13515

Mikkel H?jlund, Henrik St?vring, Kjeld Andersen, Christoph U. Correll, Jesper Hallas

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引用次数: 2

Abstract

Objective

Quetiapine use at standard doses has been associated with hyperglycemia and dyslipidemia. However, whether even frequently prescribed low-dose quetiapine results in significant metabolic disturbances remains unclear. Thus, this study aimed to investigate the association between off-label, low-dose quetiapine and changes in glycosylated hemoglobin (HbA1c) levels/lipid parameters.

Methods

We identified new users of low-dose quetiapine (≤50 mg tablets) in Denmark 2008–2018 with measurements of HbA1c, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), or fasting triglycerides (fTG) within 365 days before and after quetiapine initiation. Mixed-effects linear regression models were used to estimate coefficients (β) with 95% confidence intervals (95%CIs) for change in cardiometabolic parameters after quetiapine initiation. Inverse probability weighting was used to mitigate selection bias. Higher doses of quetiapine (>50 mg) were included in sensitivity analyses.

Results

Among 106,711 eligible new low-dose quetiapine users (median age = 45 years, females = 55%), low-dose quetiapine initiation was associated with increased fTG (β = 1.049[95%CI:1.027–1.072]) and decreased HDL-C (β = 0.982[0.978–0.986]). Although HbA1c did not change significantly and TC and LDL-C even decreased considering all subjects, all three metabolic parameters increased significantly among individuals with normal pre-quetiapine initiation levels. The adverse metabolic effect of quetiapine on HbA1c, TC, LDL-C, and HDL-C was dose-dependent, which was not the case for fTG.

Conclusions

Low-dose quetiapine was associated with a significant increase in fTG and decreases in HDL-C in all subjects, as well as with significant increases in HbA1c, TC, and LDL-C among those with normal baseline values. The risk of metabolic worsening with quetiapine was dose-dependent, except for fTG.

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低剂量喹硫平对糖化血红蛋白、甘油三酯和胆固醇水平的影响

目的标准剂量喹硫平与高血糖和血脂异常有关。然而，即使经常开低剂量喹硫平是否会导致显著的代谢紊乱仍不清楚。因此，本研究旨在探讨标签外低剂量喹硫平与糖化血红蛋白(HbA1c)水平/脂质参数变化之间的关系。方法:我们在2008-2018年在丹麦通过测量HbA1c、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)或空腹甘油三酯(fTG)在喹硫平起始前后365天内确定低剂量喹硫平(≤50 mg片剂)的新使用者。使用混合效应线性回归模型估计喹硫平开始后心脏代谢参数变化的系数(β)，置信区间为95%。采用逆概率加权来减轻选择偏差。高剂量喹硫平(50 mg)纳入敏感性分析。结果在106,711名符合条件的低剂量喹硫平新使用者(中位年龄为45岁，女性为55%)中，低剂量喹硫平起始与fTG升高(β = 1.049[95%CI: 1.027-1.072])和HDL-C降低(β = 0.982[0.978-0.986])相关。尽管所有受试者的HbA1c变化不明显，TC和LDL-C甚至下降，但在喹硫平前起始水平正常的个体中，这三个代谢参数均显著升高。喹硫平对HbA1c、TC、LDL-C和HDL-C的不良代谢作用是剂量依赖性的，而对fTG则不是这样。结论:在所有受试者中，低剂量喹硫平与fTG的显著升高和HDL-C的降低有关，在基线值正常的受试者中，与HbA1c、TC和LDL-C的显著升高有关。除了fTG外，喹硫平代谢恶化的风险是剂量依赖性的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.