One-Year Prospective Study of Liver Function Tests in Children and Adolescents on Second-Generation Antipsychotics: Is There a Link with Metabolic Syndrome?
To analyze liver function tests (LFT), weight, metabolic syndrome (MetS) and at risk of meeting MetS criteria (AR-MetS) in children and adolescents on antipsychotics (AP) during a year-long follow-up. Two hundred sixteen patients, AP naïve or quasi-naïve (
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creator | Baeza, Inmaculada de la Serna, Elena Calvo-Escalona, Rosa Merchán-Naranjo, Jessica Rodríguez-Latorre, Pamela Martínez-Cantarero, M Carmen Andrés, Patricia Alda, José Angel Muñoz-Samons, Daniel Ilzarbe, Daniel Arango, Celso Castro-Fornieles, Josefina |
description | To analyze liver function tests (LFT), weight, metabolic syndrome (MetS) and at risk of meeting MetS criteria (AR-MetS) in children and adolescents on antipsychotics (AP) during a year-long follow-up.
Two hundred sixteen patients, AP naïve or quasi-naïve ( |
doi_str_mv | 10.1089/cap.2017.0117 |
format | Article |
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Two hundred sixteen patients, AP naïve or quasi-naïve (<30 days on AP), were included. Total bilirubin, the enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), weight and other parameters of MetS were measured at baseline, and at 3, 6 and 12 months, while patients remained on the same AP.
At baseline, patients (mean age: 14.1 ± 3.1 years; 60.2% male) were on risperidone (N = 143), olanzapine (N = 37), or quetiapine (N = 36), although the sample decreased over time to 67 patients at 12 months (risperidone N = 46, olanzapine N = 10, and quetiapine N = 11). Around 3% of patients had ALT/AST levels that were at least twice the upper limit of normal (ULN) at 3 and 6 months; whereas roughly 19% of patients had ALP levels that were at least twice the ULN in at least one assessment after baseline, but had no clinical symptoms. From baseline to 6 months, significant increases were observed in ALT levels in the whole sample (p = 0.005), whereas ALP increased only in patients on risperidone. Patients showed significant weight gain, and more individuals met criteria for MetS and AR-MetS over time (from baseline: 2.8% and 8.3%, to 1 year: 10.5% and 23.9%, respectively). There was a trend-level group effect in global ALT across time (p = 0.076). Patients with MetS showed higher ALT concentrations (28.9 [18.4-39.4] U/L) than AR-MetS (20.4 [8.5-32.2] U/L), and no-AR-MetS (19.2 [8.4-29.9] U/L).
Less than 3% of children and adolescents on AP during 1-year follow-up showed an increase in ALT or AST levels in one or more of the assessments, and none of these increases was of clinical significance. Patients with MetS and AR-MetS increased during this period, and the possible role of ALT levels to monitor these patients deserves further study.</description><identifier>ISSN: 1044-5463</identifier><identifier>EISSN: 1557-8992</identifier><identifier>DOI: 10.1089/cap.2017.0117</identifier><identifier>PMID: 29975563</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Adolescents ; Alanine ; Alanine transaminase ; Alkaline phosphatase ; Antipsychotics ; Aspartate aminotransferase ; Bilirubin ; Child & adolescent psychiatry ; Children ; Children & youth ; Clinical significance ; Hepatitis ; Hospitals ; Liver ; Medicine ; Metabolic syndrome ; Metabolites ; Neurosciences ; Obesity ; Olanzapine ; Psychotropic drugs ; Quetiapine ; Risperidone ; Systematic review ; Teenagers ; Trends</subject><ispartof>Journal of child and adolescent psychopharmacology, 2018-09, Vol.28 (7), p.463-473</ispartof><rights>(©) Copyright 2018, Mary Ann Liebert, Inc., publishers</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c321t-6c9fd68ac23f9d63e4b846ffc64fb0e21358be1a683e01aea4f2f3cc65058a8d3</citedby><cites>FETCH-LOGICAL-c321t-6c9fd68ac23f9d63e4b846ffc64fb0e21358be1a683e01aea4f2f3cc65058a8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29975563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baeza, Inmaculada</creatorcontrib><creatorcontrib>de la Serna, Elena</creatorcontrib><creatorcontrib>Calvo-Escalona, Rosa</creatorcontrib><creatorcontrib>Merchán-Naranjo, Jessica</creatorcontrib><creatorcontrib>Rodríguez-Latorre, Pamela</creatorcontrib><creatorcontrib>Martínez-Cantarero, M Carmen</creatorcontrib><creatorcontrib>Andrés, Patricia</creatorcontrib><creatorcontrib>Alda, José Angel</creatorcontrib><creatorcontrib>Muñoz-Samons, Daniel</creatorcontrib><creatorcontrib>Ilzarbe, Daniel</creatorcontrib><creatorcontrib>Arango, Celso</creatorcontrib><creatorcontrib>Castro-Fornieles, Josefina</creatorcontrib><title>One-Year Prospective Study of Liver Function Tests in Children and Adolescents on Second-Generation Antipsychotics: Is There a Link with Metabolic Syndrome?</title><title>Journal of child and adolescent psychopharmacology</title><addtitle>J Child Adolesc Psychopharmacol</addtitle><description>To analyze liver function tests (LFT), weight, metabolic syndrome (MetS) and at risk of meeting MetS criteria (AR-MetS) in children and adolescents on antipsychotics (AP) during a year-long follow-up.
Two hundred sixteen patients, AP naïve or quasi-naïve (<30 days on AP), were included. Total bilirubin, the enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), weight and other parameters of MetS were measured at baseline, and at 3, 6 and 12 months, while patients remained on the same AP.
At baseline, patients (mean age: 14.1 ± 3.1 years; 60.2% male) were on risperidone (N = 143), olanzapine (N = 37), or quetiapine (N = 36), although the sample decreased over time to 67 patients at 12 months (risperidone N = 46, olanzapine N = 10, and quetiapine N = 11). Around 3% of patients had ALT/AST levels that were at least twice the upper limit of normal (ULN) at 3 and 6 months; whereas roughly 19% of patients had ALP levels that were at least twice the ULN in at least one assessment after baseline, but had no clinical symptoms. From baseline to 6 months, significant increases were observed in ALT levels in the whole sample (p = 0.005), whereas ALP increased only in patients on risperidone. Patients showed significant weight gain, and more individuals met criteria for MetS and AR-MetS over time (from baseline: 2.8% and 8.3%, to 1 year: 10.5% and 23.9%, respectively). There was a trend-level group effect in global ALT across time (p = 0.076). Patients with MetS showed higher ALT concentrations (28.9 [18.4-39.4] U/L) than AR-MetS (20.4 [8.5-32.2] U/L), and no-AR-MetS (19.2 [8.4-29.9] U/L).
Less than 3% of children and adolescents on AP during 1-year follow-up showed an increase in ALT or AST levels in one or more of the assessments, and none of these increases was of clinical significance. Patients with MetS and AR-MetS increased during this period, and the possible role of ALT levels to monitor these patients deserves further study.</description><subject>Adolescents</subject><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Alkaline phosphatase</subject><subject>Antipsychotics</subject><subject>Aspartate aminotransferase</subject><subject>Bilirubin</subject><subject>Child & adolescent psychiatry</subject><subject>Children</subject><subject>Children & youth</subject><subject>Clinical significance</subject><subject>Hepatitis</subject><subject>Hospitals</subject><subject>Liver</subject><subject>Medicine</subject><subject>Metabolic syndrome</subject><subject>Metabolites</subject><subject>Neurosciences</subject><subject>Obesity</subject><subject>Olanzapine</subject><subject>Psychotropic drugs</subject><subject>Quetiapine</subject><subject>Risperidone</subject><subject>Systematic review</subject><subject>Teenagers</subject><subject>Trends</subject><issn>1044-5463</issn><issn>1557-8992</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdkUtv1DAQgC1ERR9w5IosceGSrR-x43BBqxUtlRYVaZcDp8ixx1qXrB3sBLT_pT8WLy099OSx5_OMxx9CbylZUKLaS6PHBSO0WRBKmxfojArRVKpt2csSk7quRC35KTrP-Y4QyiWRr9Apa9tGCMnP0P1tgOoH6IS_pZhHMJP_DXgzzfaAo8Prskv4ag7lPAa8hTxl7ANe7fxgEwSsg8VLGwfIBkLJFWgDJgZbXUOApP9dW4bJj_lgdnHyJn_ENxlvd5AA69Ig_MR__LTDX2HSfRy8wZtDsCnu4dNrdOL0kOHN43qBvl993q6-VOvb65vVcl0ZzuhUSdM6K5U2jLvWSg51r2rpnJG16wkwyoXqgWqpOBCqQdeOOW6MFEQorSy_QB8e6o4p_prLjN3el3mGQQeIc-4YkbJuFBWqoO-foXdxTqG8rmPFR90wQWShqgfKlE_NCVw3Jr_X6dBR0h21dUVbd9TWHbUV_t1j1bnfg32i_3vifwHugJTq</recordid><startdate>201809</startdate><enddate>201809</enddate><creator>Baeza, Inmaculada</creator><creator>de la Serna, Elena</creator><creator>Calvo-Escalona, Rosa</creator><creator>Merchán-Naranjo, Jessica</creator><creator>Rodríguez-Latorre, Pamela</creator><creator>Martínez-Cantarero, M Carmen</creator><creator>Andrés, Patricia</creator><creator>Alda, José Angel</creator><creator>Muñoz-Samons, Daniel</creator><creator>Ilzarbe, Daniel</creator><creator>Arango, Celso</creator><creator>Castro-Fornieles, Josefina</creator><general>Mary Ann Liebert, 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Calvo-Escalona, Rosa ; Merchán-Naranjo, Jessica ; Rodríguez-Latorre, Pamela ; Martínez-Cantarero, M Carmen ; Andrés, Patricia ; Alda, José Angel ; Muñoz-Samons, Daniel ; Ilzarbe, Daniel ; Arango, Celso ; Castro-Fornieles, Josefina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c321t-6c9fd68ac23f9d63e4b846ffc64fb0e21358be1a683e01aea4f2f3cc65058a8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescents</topic><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Alkaline phosphatase</topic><topic>Antipsychotics</topic><topic>Aspartate aminotransferase</topic><topic>Bilirubin</topic><topic>Child & adolescent psychiatry</topic><topic>Children</topic><topic>Children & youth</topic><topic>Clinical significance</topic><topic>Hepatitis</topic><topic>Hospitals</topic><topic>Liver</topic><topic>Medicine</topic><topic>Metabolic syndrome</topic><topic>Metabolites</topic><topic>Neurosciences</topic><topic>Obesity</topic><topic>Olanzapine</topic><topic>Psychotropic drugs</topic><topic>Quetiapine</topic><topic>Risperidone</topic><topic>Systematic review</topic><topic>Teenagers</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baeza, Inmaculada</creatorcontrib><creatorcontrib>de la Serna, Elena</creatorcontrib><creatorcontrib>Calvo-Escalona, Rosa</creatorcontrib><creatorcontrib>Merchán-Naranjo, Jessica</creatorcontrib><creatorcontrib>Rodríguez-Latorre, Pamela</creatorcontrib><creatorcontrib>Martínez-Cantarero, M Carmen</creatorcontrib><creatorcontrib>Andrés, Patricia</creatorcontrib><creatorcontrib>Alda, José Angel</creatorcontrib><creatorcontrib>Muñoz-Samons, Daniel</creatorcontrib><creatorcontrib>Ilzarbe, Daniel</creatorcontrib><creatorcontrib>Arango, Celso</creatorcontrib><creatorcontrib>Castro-Fornieles, 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adolescent psychopharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baeza, Inmaculada</au><au>de la Serna, Elena</au><au>Calvo-Escalona, Rosa</au><au>Merchán-Naranjo, Jessica</au><au>Rodríguez-Latorre, Pamela</au><au>Martínez-Cantarero, M Carmen</au><au>Andrés, Patricia</au><au>Alda, José Angel</au><au>Muñoz-Samons, Daniel</au><au>Ilzarbe, Daniel</au><au>Arango, Celso</au><au>Castro-Fornieles, Josefina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One-Year Prospective Study of Liver Function Tests in Children and Adolescents on Second-Generation Antipsychotics: Is There a Link with Metabolic Syndrome?</atitle><jtitle>Journal of child and adolescent psychopharmacology</jtitle><addtitle>J Child Adolesc Psychopharmacol</addtitle><date>2018-09</date><risdate>2018</risdate><volume>28</volume><issue>7</issue><spage>463</spage><epage>473</epage><pages>463-473</pages><issn>1044-5463</issn><eissn>1557-8992</eissn><abstract>To analyze liver function tests (LFT), weight, metabolic syndrome (MetS) and at risk of meeting MetS criteria (AR-MetS) in children and adolescents on antipsychotics (AP) during a year-long follow-up.
Two hundred sixteen patients, AP naïve or quasi-naïve (<30 days on AP), were included. Total bilirubin, the enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), weight and other parameters of MetS were measured at baseline, and at 3, 6 and 12 months, while patients remained on the same AP.
At baseline, patients (mean age: 14.1 ± 3.1 years; 60.2% male) were on risperidone (N = 143), olanzapine (N = 37), or quetiapine (N = 36), although the sample decreased over time to 67 patients at 12 months (risperidone N = 46, olanzapine N = 10, and quetiapine N = 11). Around 3% of patients had ALT/AST levels that were at least twice the upper limit of normal (ULN) at 3 and 6 months; whereas roughly 19% of patients had ALP levels that were at least twice the ULN in at least one assessment after baseline, but had no clinical symptoms. From baseline to 6 months, significant increases were observed in ALT levels in the whole sample (p = 0.005), whereas ALP increased only in patients on risperidone. Patients showed significant weight gain, and more individuals met criteria for MetS and AR-MetS over time (from baseline: 2.8% and 8.3%, to 1 year: 10.5% and 23.9%, respectively). There was a trend-level group effect in global ALT across time (p = 0.076). Patients with MetS showed higher ALT concentrations (28.9 [18.4-39.4] U/L) than AR-MetS (20.4 [8.5-32.2] U/L), and no-AR-MetS (19.2 [8.4-29.9] U/L).
Less than 3% of children and adolescents on AP during 1-year follow-up showed an increase in ALT or AST levels in one or more of the assessments, and none of these increases was of clinical significance. Patients with MetS and AR-MetS increased during this period, and the possible role of ALT levels to monitor these patients deserves further study.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>29975563</pmid><doi>10.1089/cap.2017.0117</doi><tpages>11</tpages></addata></record> |
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subjects | Adolescents Alanine Alanine transaminase Alkaline phosphatase Antipsychotics Aspartate aminotransferase Bilirubin Child & adolescent psychiatry Children Children & youth Clinical significance Hepatitis Hospitals Liver Medicine Metabolic syndrome Metabolites Neurosciences Obesity Olanzapine Psychotropic drugs Quetiapine Risperidone Systematic review Teenagers Trends |
title | One-Year Prospective Study of Liver Function Tests in Children and Adolescents on Second-Generation Antipsychotics: Is There a Link with Metabolic Syndrome? |
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