Clin Psychopharmacol Neurosci.  2017 May;15(2):153-162. 10.9758/cpn.2017.15.2.153.

Relationship between Serum Bilirubin Levels and Metabolic Syndrome in Patients with Schizophrenia Spectrum Disorders

  • 1Department of Psychiatry, Gazi University Medical Faculty, Ankara, Turkey.
  • 2Department of Psychiatry, Pamukkale University Medical Faculty, Denizli, Turkey.
  • 3Department of Biochemistry, Pamukkale University Medical Faculty, Denizli, Turkey.
  • 4Department of Psychiatry, Tokat Dr. Cevdet Aykan Mental Health Hospital, Tokat, Turkey.
  • 5Department of Biochemistry, Fatih University Medical Faculty, Istanbul, Turkey.
  • 6Department of Psychiatry, Denizli State Hospital, Denizli, Turkey.


OBJECTIVE: We investigated the relationship between serum bilirubin levels and metabolic syndrome (MetS), and the longitudinal effects of baseline serum bilirubin concentrations on MetS in patients with schizophrenia spectrum disorders undergoing atypical antipsychotics.
The sample of this study consisted of 131 patients with schizophrenia spectrum disorders. Waist circumference, blood pressure, and levels of triglycerides, high-density lipoprotein cholesterol, fasting glucose, and insulin were evaluated at baseline and at month six. Serum bilirubin levels were measured at baseline. Serum bilirubin levels of the patients with and without MetS criteria were compared. We also compared patients with high and low bilirubin levels (upper and lower 50th percentiles of serum bilirubin levels) in terms of MetS criteria, MetS frequency, and course of MetS.
Serum direct bilirubin levels were more consistently related to MetS and MetS-related variables. The waist circumference and triglyceride criteria for MetS were significantly related to low serum direct bilirubin at baseline; waist circumference and fasting glucose criteria, and insulin resistance were associated with low serum direct bilirubin at follow-up. MetS diagnosis and the presence of the waist circumference criterion were more frequent at the baseline and the follow-up in low bilirubin group. At the end of the follow-up period, the rate of reverse MetS was significantly higher in the high bilirubin group.
Our results have suggested that serum direct bilirubin levels showed a more reliable and stable relationship with abdominal obesity for MetS patients with schizophrenia spectrum disorders using antipsychotics. Further studies are required.


Schizophrenia; Metabolic syndrome; Bilirubin; Atypical antipsychotics
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