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Olanzapine-induced weight gain plays a key role in the potential cardiovascular risk: evidence from heart rate variability analysis.

Wang J, Liu YS, Zhu WX, Zhang FQ, Zhou ZH - Sci Rep (2014)

Bottom Line: Olanzapine, a widely used antipsychotic drug, is considered to have good cardiac safety because of not causing significant corrected QT-interval (QTc) prolongation; however, it is still unclear whether olanzapine affects HRV.We found that patients who had substantial weight gain (EWG) manifested significantly lower HRV than those who had non-substantial weight gain (NWG) and that HRV decrease was positively correlated to an increase in body mass index (BMI) and weight gain.Our results indicate that olanzapine-induced weight gain may play an important role in its potential cardiovascular risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Psychiatry, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.

ABSTRACT
Patients with schizophrenia have a higher risk for cardiovascular disease (CVD) than the general population. Research has suggested that autonomic imbalance is a common pathway to increased morbidity and mortality for CVD. Heart rate variability (HRV) analysis is a non-invasive method that assesses autonomic imbalance, and low HRV is correlated with high cardiovascular risk. Olanzapine, a widely used antipsychotic drug, is considered to have good cardiac safety because of not causing significant corrected QT-interval (QTc) prolongation; however, it is still unclear whether olanzapine affects HRV. We recruited 83 patients with schizophrenia who were medication-free for at least 1 month and tested their HRV at the baseline and 4 weeks after treatment with olanzapine. We found that patients who had substantial weight gain (EWG) manifested significantly lower HRV than those who had non-substantial weight gain (NWG) and that HRV decrease was positively correlated to an increase in body mass index (BMI) and weight gain. Our results indicate that olanzapine-induced weight gain may play an important role in its potential cardiovascular risk. Since olanzapine has a very high potential for weight gain compared with other antipsychotics, further research is needed to explore its cardiovascular safety profile, specifically long-term cardiac safety.

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Related in: MedlinePlus

Correlations among changes in body mass index and HRV measurements for the SCZ, EWG and NWG groups.The change in body mass index (ΔBMI) is positively correlated with the change in the normalized low frequency power LFn (ΔLFn) and the LF/HF ratio (ΔLF/HF) and negatively correlated with the change in the standard deviation for the NN interval (ΔSDNN) and normalized high frequency power (ΔHFn) in both the SCZ and EWG groups (All P < 0.05). There is only a marginal negative correlation between ΔBMI and ΔHFn (P = 0.05) for the NWG group.
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f1: Correlations among changes in body mass index and HRV measurements for the SCZ, EWG and NWG groups.The change in body mass index (ΔBMI) is positively correlated with the change in the normalized low frequency power LFn (ΔLFn) and the LF/HF ratio (ΔLF/HF) and negatively correlated with the change in the standard deviation for the NN interval (ΔSDNN) and normalized high frequency power (ΔHFn) in both the SCZ and EWG groups (All P < 0.05). There is only a marginal negative correlation between ΔBMI and ΔHFn (P = 0.05) for the NWG group.

Mentions: We considered olanzapine dosage and the PANSS reduction rate to be confounding factors in the correlations between changes in BMI and changes in HRV indicators. For the SCZ group, BMI change (ΔBMI = BMIweek4 − BMIbaseline), which reflects normalized weight gain or loss, was positively correlated with LFn and LF/HF ratio changes, and negatively correlated with SDNN and HFn changes. Subgroup analyses revealed a similar pattern in the EWG group, whereas there was a marginal negative correlation between changes of BMI and HFn in the NWG group (Table 4). Figure 1 shows the linear regression model of changes in BMI and HRV indicators for the SCZ, EWG and NWG groups.


Olanzapine-induced weight gain plays a key role in the potential cardiovascular risk: evidence from heart rate variability analysis.

Wang J, Liu YS, Zhu WX, Zhang FQ, Zhou ZH - Sci Rep (2014)

Correlations among changes in body mass index and HRV measurements for the SCZ, EWG and NWG groups.The change in body mass index (ΔBMI) is positively correlated with the change in the normalized low frequency power LFn (ΔLFn) and the LF/HF ratio (ΔLF/HF) and negatively correlated with the change in the standard deviation for the NN interval (ΔSDNN) and normalized high frequency power (ΔHFn) in both the SCZ and EWG groups (All P < 0.05). There is only a marginal negative correlation between ΔBMI and ΔHFn (P = 0.05) for the NWG group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260225&req=5

f1: Correlations among changes in body mass index and HRV measurements for the SCZ, EWG and NWG groups.The change in body mass index (ΔBMI) is positively correlated with the change in the normalized low frequency power LFn (ΔLFn) and the LF/HF ratio (ΔLF/HF) and negatively correlated with the change in the standard deviation for the NN interval (ΔSDNN) and normalized high frequency power (ΔHFn) in both the SCZ and EWG groups (All P < 0.05). There is only a marginal negative correlation between ΔBMI and ΔHFn (P = 0.05) for the NWG group.
Mentions: We considered olanzapine dosage and the PANSS reduction rate to be confounding factors in the correlations between changes in BMI and changes in HRV indicators. For the SCZ group, BMI change (ΔBMI = BMIweek4 − BMIbaseline), which reflects normalized weight gain or loss, was positively correlated with LFn and LF/HF ratio changes, and negatively correlated with SDNN and HFn changes. Subgroup analyses revealed a similar pattern in the EWG group, whereas there was a marginal negative correlation between changes of BMI and HFn in the NWG group (Table 4). Figure 1 shows the linear regression model of changes in BMI and HRV indicators for the SCZ, EWG and NWG groups.

Bottom Line: Olanzapine, a widely used antipsychotic drug, is considered to have good cardiac safety because of not causing significant corrected QT-interval (QTc) prolongation; however, it is still unclear whether olanzapine affects HRV.We found that patients who had substantial weight gain (EWG) manifested significantly lower HRV than those who had non-substantial weight gain (NWG) and that HRV decrease was positively correlated to an increase in body mass index (BMI) and weight gain.Our results indicate that olanzapine-induced weight gain may play an important role in its potential cardiovascular risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Psychiatry, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.

ABSTRACT
Patients with schizophrenia have a higher risk for cardiovascular disease (CVD) than the general population. Research has suggested that autonomic imbalance is a common pathway to increased morbidity and mortality for CVD. Heart rate variability (HRV) analysis is a non-invasive method that assesses autonomic imbalance, and low HRV is correlated with high cardiovascular risk. Olanzapine, a widely used antipsychotic drug, is considered to have good cardiac safety because of not causing significant corrected QT-interval (QTc) prolongation; however, it is still unclear whether olanzapine affects HRV. We recruited 83 patients with schizophrenia who were medication-free for at least 1 month and tested their HRV at the baseline and 4 weeks after treatment with olanzapine. We found that patients who had substantial weight gain (EWG) manifested significantly lower HRV than those who had non-substantial weight gain (NWG) and that HRV decrease was positively correlated to an increase in body mass index (BMI) and weight gain. Our results indicate that olanzapine-induced weight gain may play an important role in its potential cardiovascular risk. Since olanzapine has a very high potential for weight gain compared with other antipsychotics, further research is needed to explore its cardiovascular safety profile, specifically long-term cardiac safety.

Show MeSH
Related in: MedlinePlus