Socio-economic position as a moderator of cardiometabolic outcomes in patients receiving psychotropic treatment associated with weight gain: results from a prospective 12-month inception cohort study and a large population-based cohort.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_4391765D562C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Socio-economic position as a moderator of cardiometabolic outcomes in patients receiving psychotropic treatment associated with weight gain: results from a prospective 12-month inception cohort study and a large population-based cohort.
Journal
Translational psychiatry
Author(s)
Dubath C., Gholam-Rezaee M., Sjaarda J., Levier A., Saigi-Morgui N., Delacrétaz A., Glatard A., Panczak R., Correll C.U., Solida A., Plessen K.J., von Gunten A., Kutalik Z., Conus P., Eap C.B.
ISSN
2158-3188 (Electronic)
ISSN-L
2158-3188
Publication state
Published
Issued date
26/06/2021
Peer-reviewed
Oui
Volume
11
Number
1
Pages
360
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Weight gain and metabolic complications are major adverse effects of many psychotropic drugs. We aimed to understand how socio-economic status (SES), defined as the Swiss socio-economic position (SSEP), is associated with cardiometabolic parameters after initiation of psychotropic medications known to induce weight gain. Cardiometabolic parameters were collected in two Swiss cohorts following the prescription of psychotropic medications. The SSEP integrated neighborhood-based income, education, occupation, and housing condition. The results were then validated in an independent replication sample (UKBiobank), using educational attainment (EA) as a proxy for SES. Adult patients with a low SSEP had a higher risk of developing metabolic syndrome over one year versus patients with a high SSEP (Hazard ratio (95% CI) = 3.1 (1.5-6.5), n = 366). During the first 6 months of follow-up, a significant negative association between SSEP and body mass index (BMI), weight change, and waist circumference change was observed (25 ≤ age < 65, n = 526), which was particularly important in adults receiving medications with the highest risk of weight gain, with a BMI difference of 0.86 kg/m <sup>2</sup> between patients with low versus high SSEP (95% CI: 0.03-1.70, n = 99). Eventually, a causal effect of EA on BMI was revealed using Mendelian randomization in the UKBiobank, which was notably strong in high-risk medication users (beta: -0.47 SD EA per 1 SD BMI; 95% CI: -0.46 to -0.27, n = 11,314). An additional aspect of personalized medicine was highlighted, suggesting the patients' SES represents a significant risk factor. Particular attention should be paid to patients with low SES when initiating high cardiometabolic risk psychotropic medications.
Keywords
Adult, Body Mass Index, Cardiovascular Diseases, Cohort Studies, Humans, Prospective Studies, Psychotropic Drugs/adverse effects, Social Class, Weight Gain
Pubmed
Web of science
Open Access
Yes
Create date
12/07/2021 8:07
Last modification date
24/07/2021 5:34
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