The Antiatherogenic Properties of HDL in Psychiatric Patients With and Without Antipsychotic Therapy
The Antiatherogenic Properties of HDL in Psychiatric Patients With and Without Antipsychotic Therapy
Background:

 Among individuals with schizophrenia, there is an increased prevalence of obesity,
 dyslipidemia ,diabetes mellitus and related conditions such as cardiovascular disease. People
 with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have
 worse physical health and reduced life expectancy compared to the general population. Number
 of epidemiological studies of patients with schizophrenia have documented a higher incidence
 of cardiovascular disease than in the general population, and patients with schizophrenia may
 be at an elevated risk for cardiovascular disease even in the absence of antipsychotic
 treatment.

 Affinity for the H1 receptor is most closely linked to increased weight gain, although
 affinity for D2, 5-HT1A, 5-HT2C and a2-receptors may also be involved. Drug affinity for the
 H1, M3 and 5-HT2C receptors is correlated with an increased risk of diabetes.

 High-density lipoprotein cholesterol (HDL-C) concentration in the blood is independently and
 inversely associated with an increased risk of cardiovascular disease(CVD). However many
 patients with 'normal' or even 'elevated' plasma HDL experience clinical events. HDL may not
 always be atheroprotective and in some conditions, it paradoxically enhances the process of
 atherosclerosis. In addition to its role in reverse cholesterol transport, HDL shows many
 other protective properties towards atherosclerosis. HDL inhibits the chemotaxis of monocytes
 , prevents endothelial dysfunction and apoptosis, prohibit slow-density lipoprotein (LDL )
 oxidation, and stimulates the proliferation of endothelial cells and smooth muscle cells.
 These anti-inﬂammatory, antioxidative, antiaggregatory, anti-coagulant, and pro-ﬁbrinolytic
 activities are exerted by different components of HDL

 Aim of the study:

 To investigate the functional properties of HDL in psychiatric patients before and during
 antipsychotic therapy.

 Patients and methods:

 The blood will be drawn at baseline before the initiation of antipsychotic drugs and 2 months
 under the antipsychotic treatment.

 Study procedures:

 Full lipid profile including triglycerides, LDL-C, Total cholesterol, HDL-cholesterol, apo
 AI, apoAII and apoB100.

 Serum Paraoxanase Activity

 LDL oxidation and resistance to oxidation (measured by conjugated diens formation during
 incubation in the presence of copper).

 HDL composition: total and unesterified cholesterol, triglycerides and phospholipids, TBARS
 content before and after exposure to AAPH as a major indicator of oxidative stress, PON
 activity using phenylacetate as a substrate, apoA1and PAF.

 Serum parameters e.g. Diacyl glycerol acyltransferase activity, free ApoA1 and LCAT activity.

 3 [H]-Cholesterol efflux will be measured by incubating J744 macrophages with serum.
 Radioactivity will measured by β counter in the cell lysate and the medium.

 Statistical methods:

 One-way AVOVA and Student's t-test for paired samples will be used for comparison of multiple
 groups and paired samples, respectively. p<0.05 will be considered significant.
Inclusion Criteria:

 -  in patients and outpatients with schizophrenia, schizoaffective and bipolar disorder
 based on psychiatrist diagnostic evaluation using DSM-IV criteria, before and at least
 two months after antipsychotic therapy will be enrolled.

 Exclusion Criteria:

 -  Unwillingness to participate in the study.