Are leptin levels increased among people with schizophrenia versus controls? A systematic review and comparative meta-analysis

Brendon Stubbs, Alexandre K. Wang, Davy Vancampfort, Brian J Miller

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Objective: Leptin may play a role in the pathophysiology of schizophrenia and it remains unclear if levels are raised compared to controls. Therefore, we performed a systematic review and meta-analysis comparing leptin levels among people with schizophrenia and controls. Method: Two authors independently searched major electronic databases from inception until June 2015 for studies measuring blood leptin levels among people with schizophrenia and controls. Random effects meta-analysis calculating hedges g and 95% confidence intervals (CI) and meta-regression analyses were conducted. Results: Twenty-seven articles representing 1674 individuals with schizophrenia (34.6 ± 6.8 years, 55% male (0-100%), BMI 25.2 ± 3.1) and 2033 controls (33.9 ± 7.0 years, 51% male (0-100%), BMI = 24.1 ± 2.1) were included. Across all studies, leptin levels may be marginally higher in schizophrenia (g = 0.164, 95% CI -0.014-0.341, p = 0.07, Q = 217, p < 0.01), particularly when one outlier was removed (g = 0.196, 95% CI 0.210-0.370, p = 0.02) and when we included the smallest effect size from studies with multiple comparisons (g = 0.318, 95% CI 0.125-0.510, p = 0.001). Leptin levels were higher in multi-episode schizophrenia (g = 0.245, 95% CI 0.058-0.433, p = 0.01) and females (g = 0.557 95% CI 0.16-0.954, p = 0.006). Subgroup analyses revealed leptin levels may be higher in participants taking second-generation antipsychotics compared to controls. Multivariate meta-regression demonstrated a lower percentage of males (β = -0.0064, 95% CI -0.0129 to -0.0002, p = 0.05), but not BMI, moderated the results. Conclusion: Our results suggest that schizophrenia is associated with increased blood leptin levels compared to controls, which may not be entirely attributable to antipsychotic medication or BMI. Other illness related and lifestyle choices may play a pivotal role.

Original languageEnglish (US)
Pages (from-to)144-154
Number of pages11
JournalPsychoneuroendocrinology
Volume63
DOIs
StatePublished - Jan 1 2016

Fingerprint

Leptin
Meta-Analysis
Schizophrenia
Confidence Intervals
Antipsychotic Agents
Life Style
Regression Analysis
Databases

Keywords

  • Leptin
  • Meta-analysis
  • Metabolism
  • Obesity
  • Schizophrenia

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Endocrine and Autonomic Systems
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Are leptin levels increased among people with schizophrenia versus controls? A systematic review and comparative meta-analysis. / Stubbs, Brendon; Wang, Alexandre K.; Vancampfort, Davy; Miller, Brian J.

In: Psychoneuroendocrinology, Vol. 63, 01.01.2016, p. 144-154.

Research output: Contribution to journalReview article

@article{d9c48a2432574bb694df371a1e8d2a50,
title = "Are leptin levels increased among people with schizophrenia versus controls? A systematic review and comparative meta-analysis",
abstract = "Objective: Leptin may play a role in the pathophysiology of schizophrenia and it remains unclear if levels are raised compared to controls. Therefore, we performed a systematic review and meta-analysis comparing leptin levels among people with schizophrenia and controls. Method: Two authors independently searched major electronic databases from inception until June 2015 for studies measuring blood leptin levels among people with schizophrenia and controls. Random effects meta-analysis calculating hedges g and 95{\%} confidence intervals (CI) and meta-regression analyses were conducted. Results: Twenty-seven articles representing 1674 individuals with schizophrenia (34.6 ± 6.8 years, 55{\%} male (0-100{\%}), BMI 25.2 ± 3.1) and 2033 controls (33.9 ± 7.0 years, 51{\%} male (0-100{\%}), BMI = 24.1 ± 2.1) were included. Across all studies, leptin levels may be marginally higher in schizophrenia (g = 0.164, 95{\%} CI -0.014-0.341, p = 0.07, Q = 217, p < 0.01), particularly when one outlier was removed (g = 0.196, 95{\%} CI 0.210-0.370, p = 0.02) and when we included the smallest effect size from studies with multiple comparisons (g = 0.318, 95{\%} CI 0.125-0.510, p = 0.001). Leptin levels were higher in multi-episode schizophrenia (g = 0.245, 95{\%} CI 0.058-0.433, p = 0.01) and females (g = 0.557 95{\%} CI 0.16-0.954, p = 0.006). Subgroup analyses revealed leptin levels may be higher in participants taking second-generation antipsychotics compared to controls. Multivariate meta-regression demonstrated a lower percentage of males (β = -0.0064, 95{\%} CI -0.0129 to -0.0002, p = 0.05), but not BMI, moderated the results. Conclusion: Our results suggest that schizophrenia is associated with increased blood leptin levels compared to controls, which may not be entirely attributable to antipsychotic medication or BMI. Other illness related and lifestyle choices may play a pivotal role.",
keywords = "Leptin, Meta-analysis, Metabolism, Obesity, Schizophrenia",
author = "Brendon Stubbs and Wang, {Alexandre K.} and Davy Vancampfort and Miller, {Brian J}",
year = "2016",
month = "1",
day = "1",
doi = "10.1016/j.psyneuen.2015.09.026",
language = "English (US)",
volume = "63",
pages = "144--154",
journal = "Psychoneuroendocrinology",
issn = "0306-4530",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Are leptin levels increased among people with schizophrenia versus controls? A systematic review and comparative meta-analysis

AU - Stubbs, Brendon

AU - Wang, Alexandre K.

AU - Vancampfort, Davy

AU - Miller, Brian J

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective: Leptin may play a role in the pathophysiology of schizophrenia and it remains unclear if levels are raised compared to controls. Therefore, we performed a systematic review and meta-analysis comparing leptin levels among people with schizophrenia and controls. Method: Two authors independently searched major electronic databases from inception until June 2015 for studies measuring blood leptin levels among people with schizophrenia and controls. Random effects meta-analysis calculating hedges g and 95% confidence intervals (CI) and meta-regression analyses were conducted. Results: Twenty-seven articles representing 1674 individuals with schizophrenia (34.6 ± 6.8 years, 55% male (0-100%), BMI 25.2 ± 3.1) and 2033 controls (33.9 ± 7.0 years, 51% male (0-100%), BMI = 24.1 ± 2.1) were included. Across all studies, leptin levels may be marginally higher in schizophrenia (g = 0.164, 95% CI -0.014-0.341, p = 0.07, Q = 217, p < 0.01), particularly when one outlier was removed (g = 0.196, 95% CI 0.210-0.370, p = 0.02) and when we included the smallest effect size from studies with multiple comparisons (g = 0.318, 95% CI 0.125-0.510, p = 0.001). Leptin levels were higher in multi-episode schizophrenia (g = 0.245, 95% CI 0.058-0.433, p = 0.01) and females (g = 0.557 95% CI 0.16-0.954, p = 0.006). Subgroup analyses revealed leptin levels may be higher in participants taking second-generation antipsychotics compared to controls. Multivariate meta-regression demonstrated a lower percentage of males (β = -0.0064, 95% CI -0.0129 to -0.0002, p = 0.05), but not BMI, moderated the results. Conclusion: Our results suggest that schizophrenia is associated with increased blood leptin levels compared to controls, which may not be entirely attributable to antipsychotic medication or BMI. Other illness related and lifestyle choices may play a pivotal role.

AB - Objective: Leptin may play a role in the pathophysiology of schizophrenia and it remains unclear if levels are raised compared to controls. Therefore, we performed a systematic review and meta-analysis comparing leptin levels among people with schizophrenia and controls. Method: Two authors independently searched major electronic databases from inception until June 2015 for studies measuring blood leptin levels among people with schizophrenia and controls. Random effects meta-analysis calculating hedges g and 95% confidence intervals (CI) and meta-regression analyses were conducted. Results: Twenty-seven articles representing 1674 individuals with schizophrenia (34.6 ± 6.8 years, 55% male (0-100%), BMI 25.2 ± 3.1) and 2033 controls (33.9 ± 7.0 years, 51% male (0-100%), BMI = 24.1 ± 2.1) were included. Across all studies, leptin levels may be marginally higher in schizophrenia (g = 0.164, 95% CI -0.014-0.341, p = 0.07, Q = 217, p < 0.01), particularly when one outlier was removed (g = 0.196, 95% CI 0.210-0.370, p = 0.02) and when we included the smallest effect size from studies with multiple comparisons (g = 0.318, 95% CI 0.125-0.510, p = 0.001). Leptin levels were higher in multi-episode schizophrenia (g = 0.245, 95% CI 0.058-0.433, p = 0.01) and females (g = 0.557 95% CI 0.16-0.954, p = 0.006). Subgroup analyses revealed leptin levels may be higher in participants taking second-generation antipsychotics compared to controls. Multivariate meta-regression demonstrated a lower percentage of males (β = -0.0064, 95% CI -0.0129 to -0.0002, p = 0.05), but not BMI, moderated the results. Conclusion: Our results suggest that schizophrenia is associated with increased blood leptin levels compared to controls, which may not be entirely attributable to antipsychotic medication or BMI. Other illness related and lifestyle choices may play a pivotal role.

KW - Leptin

KW - Meta-analysis

KW - Metabolism

KW - Obesity

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=84949764897&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949764897&partnerID=8YFLogxK

U2 - 10.1016/j.psyneuen.2015.09.026

DO - 10.1016/j.psyneuen.2015.09.026

M3 - Review article

C2 - 26444588

AN - SCOPUS:84949764897

VL - 63

SP - 144

EP - 154

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

SN - 0306-4530

ER -