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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Veröffentlicht in:Journal of child and adolescent psychopharmacology 2018-09, Vol.28 (7), p.463-473
Hauptverfasser: 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
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container_end_page 473
container_issue 7
container_start_page 463
container_title Journal of child and adolescent psychopharmacology
container_volume 28
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
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Two hundred sixteen patients, AP naïve or quasi-naïve (&lt;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 &amp; adolescent psychiatry ; Children ; Children &amp; 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 (&lt;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 &amp; adolescent psychiatry</subject><subject>Children</subject><subject>Children &amp; 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, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7RV</scope><scope>7TK</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201809</creationdate><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><author>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</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 &amp; adolescent psychiatry</topic><topic>Children</topic><topic>Children &amp; 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, Josefina</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Nursing &amp; 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Two hundred sixteen patients, AP naïve or quasi-naïve (&lt;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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