Circulating IGFBP-2 levels reveal atherogenic metabolic risk in schizophrenic patients using atypical antipsychotics

World J Biol Psychiatry. 2021 Mar;22(3):175-182. doi: 10.1080/15622975.2020.1770858. Epub 2020 Jun 17.


Objectives: Second generation antipsychotics (SGAs) induce weight gain and dyslipidemia, albeit with important intervariability. Insulin-like growth factor binding protein (IGFBP)-2 is proposed as a circulating biomarker negatively associated with waist circumference and hypertriglyceridemia. Thus, we tested whether metabolic alterations developed upon the use of SGAs are associated with plasma IGFBP-2 levels.

Methods: A cross-sectional study was performed in 87 men newly diagnosed with schizophrenia and administered for approximately 20 months with olanzapine or risperidone as their first antipsychotic treatment. Plasma IGFBP-2 concentration, anthropometric data, as well as glucose and lipid profiles were determined at the end of the treatments.

Results: IGFBP-2 levels were similar between patients using olanzapine or risperidone and were negatively correlated with waist circumference, insulin sensitivity, and plasma triglycerides (TG). A higher proportion of men with a hypertriglyceridemic (hyperTG) waist phenotype was found in patients with IGFBP-2 levels lower than 220 ng/mL (43% for olanzapine and 13% for risperidone) compared to those with IGFBP-2 above this threshold (10% and 0%, respectively).

Conclusions: IGFBP-2 may have a role in altering metabolic risk in schizophrenic patients using SGAs. Longitudinal studies are required to evaluate whether IGFBP-2 can predict the development of a hyperTG waist phenotype in this population.

Keywords: Humans; antipsychotics; cardiometabolic risk; dyslipidaemia; obesity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antipsychotic Agents* / adverse effects
  • Benzodiazepines / adverse effects
  • Cross-Sectional Studies
  • Humans
  • Insulin-Like Growth Factor Binding Protein 2
  • Male
  • Risperidone / adverse effects
  • Schizophrenia* / drug therapy


  • Antipsychotic Agents
  • Insulin-Like Growth Factor Binding Protein 2
  • Benzodiazepines
  • Risperidone

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