To preliminarily explore the possible profile of lipid metabolism abnormality and the effect of antipsychotics withdrawal on lipid metabolism of patients with schizophrenia.

All 131 in-patients with schizophrenia, admitted to our hospital from October 2009 to October 2012, were chosen and divided into three groups: drug-naive first-episode patients (group A, n=70), patients with continuous antipsychotics administration (group B, n=33) and patients with antipsychotics withdrawal for at least three months (group C, n=28); positive and negative syndrome scale was used to assess the psychopathological symptoms. Other 44 healthy adults were enrolled into the clinic research as controls (group D). At baseline, the demographic characteristics were collected. The weight, height, waist circumference, hipline, and plasma fasting lipid levels were tested at admission. The blood lipid profiles in patients from groups A and D were compared to explore the lipid metabolism abnormality. The blood lipid profiles in patients from groups A, B and C were compared to explore the effects from antipsychotics withdrawal on lipid metabolism of patients with schizophrenia.

The fasting plasma levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (aPOA1) in group A ([1.29±0.26] mmol/L and [1.20±0.22] g/L) were significantly lower than those of group D ([1.58±0.31] mmol/L and [1.40±0.20] g/L, P<0.05). The body mass index (BMI), waist circumference, and waist-hip ratio in group B ([23.09±3.92] kg/m², [81.87±9.35] cm and [0.89±0.06]) were significantly higher than those of group A ([19.63±2.53] kg/m², [70.42±7.63] cm and [0.82±0.06]); the HDL-C level in group B ([1.09±0.24] mmol/L) was statistically lower than that of group A ([1.29±0.26] mmol/L, P<0.05). The BMI and waist circumference in group C ([22.28±4.19] kg/m² and [78.92±10.94] cm) were larger than those of group A ([19.63±2.53] kg/m² and [70.42±7.63] cm), and the fasting plasma HDL-C level in group C ([1.12±0.29] mmol/L) was lower than that of group A ([1.29±0.26] mmol/L) with significantly differences (P<0.05). No significant difference of lipid profile was found between group C and B (P>0.05). The multiple regression analysis showed that fasting plasma HDL-C level of patients with schizophrenia was negatively correlated with waist circumference (B=-0.670, t=-4.909, P=0.000), and positively correlated with aPOA1 level (B=0.713, t=13.137, P=0.000).

The possible profile of lipid metabolism abnormality in patients with schizophrenia is shown as the descending of HDL-C level and aPOA1. Antipsychotics discontinuation cannot reverse the abnormal lipid profile in patients with schizophrenia.

Schizophrenia; Blood lipid metabolism; High-density lipoprotein cholesterol; Apolipoprotein A1