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<p>Second-generation antipsychotics (SGAs) were found to have varying metabolic side-effects for patients with schizophrenia, while no studies have examined the associations between adding or switching low-risk SGAs and metabolic outcomes. This real-world observational study aimed to examine the association of adding or switching to low-risk SGAs with metabolic syndrome and metabolic abnormalities for patients with schizophrenia from 25 healthcare organizations across Zhejiang Province, China. Participants were dichotomized into the low-risk SGAs group and the high/intermediate SGAs group according to whether adding or switching to low-risk SGAs. A 1:1 propensity score matching (PSM) using a nearest-neighbor method was conducted to balance the baseline characteristics between groups. The mean [standard deviation (SD)] age of included patients was 50.0 (12.4) years, and 288 (37.7%) were women. The PSM yielded 223 matched pairs, with no between-group differences in baseline characteristics. Compared to the high/intermediate SGAs group, the low-risk SGAs group showed consistent decreases in the proportion of participants with metabolic syndrome [e.g., at 6 months: risk differences = 19.28%, 95% confidence interval (CI) = −28.19% to −10.38%; odds ratio = 0.47, 95% CI = 0.30 to 0.72] and the number of metabolic abnormalities [e.g., at 6 months: mean difference (MD) = −0.52, 95% CI = −0.75 to −0.29; relative risk = 0.79, 95% CI = 0.71 to 0.87]. The low-risk SGAs group presented significant improvement in metabolic parameters, including lower levels of weight, glucose and triglyceride (e.g., for triglycerise, (MD = −0.41 mmol/L, 95% CI = −0.61 to −0.21 mmol/L at 6 months), compared to the high/intermediate risk SGAs group. These assocaitions were more pronounced in those with no comorbid physical conditions, lower BMI, shorter duration and reporting smoking or drinking. Adding or switching to low-risk antipsychotics was associated with a decrease in metabolic outcomes, which can be considered as an appropriate secondary prevention strategy for patients with both schizophrenia and metabolic abnormalities.</p>

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Associations between second-generation antipsychotics and metabolic outcomes in patients with schizophrenia and metabolic abnormalities

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月3日

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  • Zhengluan Liao,
  • Yaguan Zhou,
  • Junjie Lin,
  • Suhong Ye,
  • Haihang Yu,
  • Xilong Jin,
  • Lixiu Wei,
  • Guidong Zhu,
  • Zhiyong Lan,
  • Kedeng Fu,
  • Tiantian Zu,
  • Li Ni,
  • Yingying Dong,
  • Heqiu Wang,
  • Yong Zhou,
  • Wei Lv,
  • Juan Huang,
  • Hongfei Wang,
  • Xueming Xu,
  • Xiao Qian,
  • Wanzhen Wu,
  • Liying Liu,
  • Huabin Liu,
  • HuanPing Zhan,
  • Yanbo Chen,
  • Zhilian Pi,
  • Minghua Xie,
  • Xiaolin Xu,
  • Enyan Yu

摘要

Second-generation antipsychotics (SGAs) were found to have varying metabolic side-effects for patients with schizophrenia, while no studies have examined the associations between adding or switching low-risk SGAs and metabolic outcomes. This real-world observational study aimed to examine the association of adding or switching to low-risk SGAs with metabolic syndrome and metabolic abnormalities for patients with schizophrenia from 25 healthcare organizations across Zhejiang Province, China. Participants were dichotomized into the low-risk SGAs group and the high/intermediate SGAs group according to whether adding or switching to low-risk SGAs. A 1:1 propensity score matching (PSM) using a nearest-neighbor method was conducted to balance the baseline characteristics between groups. The mean [standard deviation (SD)] age of included patients was 50.0 (12.4) years, and 288 (37.7%) were women. The PSM yielded 223 matched pairs, with no between-group differences in baseline characteristics. Compared to the high/intermediate SGAs group, the low-risk SGAs group showed consistent decreases in the proportion of participants with metabolic syndrome [e.g., at 6 months: risk differences = 19.28%, 95% confidence interval (CI) = −28.19% to −10.38%; odds ratio = 0.47, 95% CI = 0.30 to 0.72] and the number of metabolic abnormalities [e.g., at 6 months: mean difference (MD) = −0.52, 95% CI = −0.75 to −0.29; relative risk = 0.79, 95% CI = 0.71 to 0.87]. The low-risk SGAs group presented significant improvement in metabolic parameters, including lower levels of weight, glucose and triglyceride (e.g., for triglycerise, (MD = −0.41 mmol/L, 95% CI = −0.61 to −0.21 mmol/L at 6 months), compared to the high/intermediate risk SGAs group. These assocaitions were more pronounced in those with no comorbid physical conditions, lower BMI, shorter duration and reporting smoking or drinking. Adding or switching to low-risk antipsychotics was associated with a decrease in metabolic outcomes, which can be considered as an appropriate secondary prevention strategy for patients with both schizophrenia and metabolic abnormalities.