Fri. Oct 11, 2019 10:30 AM - 12:10 PM Room 7 (403)

Organizer / Chair: ‌Mong-Liang LU (Department of Psychiatry, Wan-Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taiwan), Co-chair: Takashi WATANABE (Department of Psychiatry, Dokkyo Medical University School of Medicine, Japan), Discussants: ‌Catherine WEISS (Otsuka Pharmaceutical Development & Commercialization Inc, USA), Michiko FUJIMOTO (Department of Psychiatry, Osaka University Graduate School of Medicine, Japan)

The metabolic syndrome is highly prevalent in patients with schizophrenia patients and represents an enormous source of cardiovascular risk and mortality. Appetite-regulating hormones, pharmacodynamics and alterations in glucose metabolism may underlie the negative effect of antipsychotic medications. In this symposium, we provide the multidimensional approach to metabolic disturbance in schizophrenia from the aspects of epidemiology, therapeutic drug monitoring, and potential biomarkers.
Prof. Lu ML: Acyl/Desacyl ghrelin ratio as a potential biomarker for metabolic syndrome in patients with schizophrenia
Circulating ghrelin is presented in two major forms, acyl ghrelin and desacyl ghrelin. Both ghrelin forms can mediate energy metabolism and may act antagonistically. This suggests a crucial role for the acyl/desacyl ghrelin ratio in the energy homeostasis. In this study, we found that acyl/desacyl ghrelin ratio was more strongly correlated with metabolic syndrome components than total ghrelin and desacyl ghrelin with them. And acyl/desacyl ghrelin ratio had a higher discriminative ability to differentiate patients with metabolic syndrome from those without metabolic syndrome than either total ghrelin or desacyl ghrelin. Our study results suggest that acyl/desacyl ghrelin ratio may be a preferential marker of metabolic syndrome in patients with schizophrenia
Prof. Wu TH: Therapeutic Drug Monitoring of olanzapine and its desmethylaed metabolite in schizophrenic patients
Therapeutic drug monitoring of olanzapine (OLZ) and its desmethylated metabolite (DMO) were applied to identify the roles of the olanzapine methylation metabolite in metabolic and efficacy regulation of schizophrenic patients. In summary, our studies revealed that COLZ≧22.77ng/mL was a positive predictor of therapeutic efficacy in patients with schizophrenia and it was proposed that the optimal OLZ treatment should maintain concentrations ratio of OLZ/DMO between 3 and 6 to maximize the clinical efficacy and minimize the metabolic side effects.
Dr. Chen BY: Orexin-A may plays the role in regulating metabolic status in patient with schizophrenia taking antipsychotics
Orexin-A promotes thermogenesis and energy expenditure via increasing sympathetic tone and this effect is supressed by antipsychotics treatment. We found that orexin-A is up-regulated in antipsychotics-treated patients with schizophrenia, especially for the group taking less obesogenic antipsychotics. Furthermore, higher orexin-A levels are associated with better metabolic outcomes. These observations suggest orexin-A may have a protective effect against the development of metabolic abnormalities in schizophrenia patients receiving long-term antipsychotic treatment.
Dr. Sugai T: Characteristics of physical risk in Japanese patients with schizophrenia
We investigated the risk of metabolic syndrome and underweight by questionnaire, and there were 7655 outpatients and 15461 inpatients with schizophrenia. The result revealed that metabolic syndrome prevalence in Japanese outpatients was approximately 3-fold higher than in inpatients. On the other hand, the prevalence of underweight and under-nutrition in Japanese inpatients with schizophrenia was higher than in outpatients and the general population. The results also suggest that the difference in physical health between outpatients and inpatients with schizophrenia may be related to the mental health system in Japan. We should pay more attention to the risk of physical disease in Japanese patients with schizophrenia, considering the difference in health characteristics between outpatients and inpatients in clinical practice.