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Ellingrod VL, Taylor SF, Brook RD, Evans SJ, Zöllner SK, Grove TB, Gardner KM, Bly MJ, Pop-Busui R, Dalack G. Dietary, lifestyle and pharmacogenetic factors associated with arteriole endothelial-dependent vasodilatation in schizophrenia patients treated with atypical antipsychotics (AAPs). Schizophr Res 2011; 130:20-6. [PMID: 21504842 PMCID: PMC3139795 DOI: 10.1016/j.schres.2011.03.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 03/24/2011] [Accepted: 03/29/2011] [Indexed: 01/15/2023]
Abstract
PURPOSE Within schizophrenia cardiovascular disease (CVD) is highly prevalent secondary to atypical antipsychotic (AAP) use. Thorough assessments of diet, lifestyle, and endothelial functioning have not been done in this population. Omega 3 Fatty Acids (N-3 FAs) have garnered attention in relation to psychopathology as well as cardioprotection. This study examined the status of endothelial function within the schizophrenia population and determined pharmacogenetic, medication, dietary, and lifestyle factors associated with this functioning. METHODS Schizophrenia subjects were screened for the metabolic syndrome along with physical activity, smoking, and variants related to folate pharmacogenetics in this cross-sectional analysis. Arteriole endothelial-dependent vasodilatation was measured using non-invasive peripheral arterial tonometry (RH-PAT, EndoPAT2000). A 24h dietary food recall was used to construct intake profiles using the Nutrition Data Systems for Research software (NDSR). We examined associations between AAP use and RH-PAT values, and the influence of N-3 FA dietary intake on this measure. Preliminary data are reported in 83 subjects with a mean age (±s.d.) of 45.89 (±11.49), 64% were Caucasian (n=53), 64% were male (n=53), and 77% were receiving AAP treatment (n=63). RESULTS A significant positive relationship was found between RH-PAT values and N-3 FA intake (F=17.7(1,16), p=0.0007) in subjects not receiving AAPs. This relationship was lost in those treated with AAPs (F=0.25(1,43), p>0.6). Regression analysis confirmed the interaction effect of AAP treatment on the relationship between RH-PAT and N-3 FAs (p=0.0105). Endothelial dysfunction was also related to folate pharmacogenetic variants. CONCLUSIONS AAPs may counteract some vascular health benefits of a diet high in N-3 FAs. AAP use may necessitate a higher N-3 FA dose to regain these effects, but additional research is necessary to strengthen the preliminary findings. Pharmacogenetic variants related to folate and homocysteine metabolism may also increase endothelial dysfunction risk.
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Affiliation(s)
- Vicki L. Ellingrod
- University of Michigan, College of Pharmacy, Department of Clinical Social and Administrative Sciences, 428 Church Street, Ann Arbor, Michigan 48109, USA, University of Michigan, School of Medicine, Department of Psychiatry, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Stephan F. Taylor
- University of Michigan, School of Medicine, Department of Psychiatry, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Robert D. Brook
- University of Michigan, School of Medicine, Department of Cardiology, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109, USA
| | - Simon J. Evans
- University of Michigan, School of Medicine, Department of Psychiatry, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Sebastian K. Zöllner
- University of Michigan, School of Medicine, Department of Psychiatry, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA, University of Michigan, School of Public Health, Department of Biostatistics, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI 48109, USA
| | - Tyler B. Grove
- University of Michigan, College of Pharmacy, Department of Clinical Social and Administrative Sciences, 428 Church Street, Ann Arbor, Michigan 48109, USA, University of Michigan, School of Medicine, Department of Psychiatry, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Kristen M. Gardner
- University of Michigan, College of Pharmacy, Department of Clinical Social and Administrative Sciences, 428 Church Street, Ann Arbor, Michigan 48109, USA
| | - Michael J. Bly
- University of Michigan, College of Pharmacy, Department of Clinical Social and Administrative Sciences, 428 Church Street, Ann Arbor, Michigan 48109, USA
| | - Rodica Pop-Busui
- University of Michigan, School of Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Suite 5100, Brehm Tower 1000 Wall Street, 5th floor SPC 5714 Ann Arbor, Michigan, 48105, USA
| | - Gregory Dalack
- University of Michigan, School of Medicine, Department of Psychiatry, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
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