Early changes of blood lipid levels during psychotropic drug treatment as predictors of long-term lipid changes and of new onset dyslipidemia.

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Serval ID
serval:BIB_B3A7B269E9CC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Early changes of blood lipid levels during psychotropic drug treatment as predictors of long-term lipid changes and of new onset dyslipidemia.
Journal
Journal of clinical lipidology
Author(s)
Delacrétaz A., Vandenberghe F., Gholam-Rezaee M., Saigi Morgui N., Glatard A., Thonney J., Solida-Tozzi A., Kolly S., Gallo S.F., Baumann P., Berney S., Zulauff S.V., Aubry J.M., Hasler R., Ebbing K., von Gunten A., Conus P., Eap C.B.
ISSN
1933-2874 (Print)
ISSN-L
1876-4789
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
12
Number
1
Pages
219-229
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Cardiovascular diseases and dyslipidemia represent a major health issue in psychiatry. Many psychotropic drugs can induce a rapid and substantial increase of blood lipid levels.
This study aimed to determine the potential predictive power of an early change of blood lipid levels during psychotropic treatment on long-term change and on dyslipidemia development.
Data were obtained from a prospective study including 181 psychiatric patients with metabolic parameters monitored during the first year of treatment and with adherence ascertained. Blood lipid levels (ie, total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and fasting triglycerides [TGs]) were measured at baseline and after 1, 3, and/or 12 months of treatment.
Receiver-operating characteristic analyses indicated that early (ie, after 1 month of psychotropic treatment) increases (≥5%) for TC, LDL-C, TG, and non-HDL-C and decrease (≥5%) for HDL-C were the best predictors for clinically relevant modifications of blood lipid levels after 3 months of treatment (≥30% TC, ≥40% LDL-C, ≥45% TG, ≥55% non-HDL-C increase, and ≥20% HDL-C decrease; sensitivity 70%-100%, specificity 53%-72%). Predictive powers of these models were confirmed by fitting longitudinal multivariate models in the same cohort (P ≤ .03) as well as in a replication cohort (n = 79; P ≤ .003). Survival models showed significantly higher incidences of new onset dyslipidemia (TC, LDL-C, and non-HDL-C hypercholesterolemia, HDL-C hypocholesterolemia, and hypertriglyceridemia) for patients with early changes of blood lipid levels compared to others (P ≤ .01).
Early modifications of blood lipid levels following prescription of psychotropic drugs inducing dyslipidemia should therefore raise questions on clinical strategies to control long-term dyslipidemia.
Keywords
Adult, Area Under Curve, Cholesterol, HDL/blood, Cholesterol, LDL/blood, Dyslipidemias/diagnosis, Dyslipidemias/epidemiology, Dyslipidemias/mortality, Female, Humans, Incidence, Kaplan-Meier Estimate, Logistic Models, Male, Mental Disorders/drug therapy, Middle Aged, Predictive Value of Tests, Psychotropic Drugs/adverse effects, Psychotropic Drugs/therapeutic use, ROC Curve, Triglycerides/blood, Young Adult, Early lipid changes, Metabolic follow-up, New onset dyslipidemia, Predictors, Psychotropic drugs
Pubmed
Web of science
Open Access
Yes
Create date
14/11/2017 11:24
Last modification date
12/08/2021 6:40
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