HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: dc06-2057v1 30/6/1425    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Poa, N. R. Articles by Edgar, P. F. Search for Related Content PubMed PubMed Citation Articles by Poa, N. R. Articles by Edgar, P. F. Social Bookmarking                What's this?

Insulin Resistance is Associated with Hypercortisolemia in Polynesian Patients Treated with Antipsychotic Medication

¹Molecular Psychiatry Research Group, Christchurch School of Medicine & Health Science, University of Otago, Christchurch, New Zealand

nicola.poa{at}chmeds.ac.nz

ABSTRACT

OBJECTIVE-: Type 2 diabetes is more prevalent in the indigenous Polynesian population of New Zealand (Maori) than in Europeans. The aim of this study was to determine whether insulin resistance in Maori psychiatric patients was associated with antipsychotic treatment and to investigate the mechanism of an association.

RESEARCH DESIGN AND METHODS-: Thirty adult Maori psychiatric patients receiving antipsychotic medication for longer than six months and thirty healthy, age, gender and BMI matched controls were enrolled. Early morning fasting blood samples were analysed for plasma levels of glucose, insulin, HbA_1c, triglycerides, total cholesterol, IGF-1, cortisol, cortisol binding globulin (CBG), and adiponectin.

RESULTS-: The patient group had significantly higher median fasting insulin plasma levels compared with the control group (p = 0.002), which was independent of BMI, age and gender. In addition, the patient group had significantly higher total cortisol (p = 0.03) and lower CBG levels (p = 0.004) resulting in significantly higher levels of free cortisol (p = 0.004) than the control group. The patient group was also significantly more hypoglycemic (p = 0.026) and hypertriglyceridemic (p = 0.028) than the control group. There was no significant difference in BMI, waist circumference, HbA_1c, total cholesterol, IGF-1 or adiponectin levels between the two groups.

CONCLUSION-: An increase in insulin resistance is associated with Maori psychiatric patients treated with antipsychotic medication. Therefore, Polynesian ethnicity should be considered in prescribing practice and general care of this group. In addition, the hypothalamic pituitary adrenal axis may have an important role in the mechanism by which this insulin resistance develops.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?