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Effects of omega-3 fatty acids on metabolic syndrome in patients with schizophrenia: a 12-week randomized placebo-controlled trial

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Abstract

Rationale

Individuals with schizophrenia are at increased risk of developing metabolic syndrome (MetS) due to their lifestyle and antipsychotic treatment. Our previous study showed that patients with both schizophrenia and MetS present an increased expression and production of tumor necrosis factor-alpha (TNF-alpha). Omega-3 fatty acids have a documented role in suppressing TNF-alpha; therefore, we hypothesized that they may be of value in relieving inflammation and improving metabolic disturbance in patients with both schizophrenia and MetS.

Objectives

This study employed a randomized placebo-controlled trial to investigate the effects of omega-3 fatty acids on MetS in patients with schizophrenia.

Methods

We recruited 80 patients with both schizophrenia and MetS who received long-term olanzapine monotherapy. The patients were randomly assigned to the OMG-3 group (n = 40) or the placebo group (n = 40).

Results

Patients with both schizophrenia and MetS had significantly higher levels of TNF-alpha than the control subjects (Z = − 4.37, P < 0.01). There was a significant correlation between omega-3 fatty acid treatment and reduced triglyceride (TG) levels (Fgroup × time = 13.42; df = 1, 66; P < 0.01) when the patients completed this study. Along with metabolic improvement, omega-3 fatty acids decreased TNF-alpha levels after 12 weeks of treatment (Fgroup × time = 6.71; df = 1, 66; P = 0.012). We also found that the extent of TNF-alpha decrease was significantly correlated with that of TG decrease (r = 0.38, P = 0.001).

Conclusions

Our findings provide suggestive evidence that omega-3 fatty acids have beneficial effects on TG metabolism in patients with both schizophrenia and MetS that parallel decreased inflammation levels.

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Acknowledgements

We are deeply grateful to all participants.

Funding

This work was supported by the National Natural Science Foundation of China (81471358 and 81771450), the Shanghai Science and Technology Commission Foundation (14411969000), the Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support (20152530), the Shanghai Municipal Commission of Health and Family Planning Foundation (201540029), and the Shanghai Municipal Commission of Health and Family Planning, Key Developing Disciplines (2015ZB0405).

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Author notes

  1. Feikang Xu and Weixing Fan contributed equally to this work.

Authors and Affiliations

  1. Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Feikang Xu, Yi Zhang, Jun Cai, Lisheng Song & Chen Zhang

  2. Department of Psychiatry, Jinhua Second Hospital, Jinhua, Zhejiang, China

    Weixing Fan & Weiping Wang

  3. Department of Psychiatry, Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China

    Wei Tang, Fuyin Yang & Chen Zhang

  4. Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China

    Fuyin Yang

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  1. Feikang Xu
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  2. Weixing Fan
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  3. Weiping Wang
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  4. Wei Tang
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  9. Chen Zhang
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Corresponding author

Correspondence to Chen Zhang.

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All procedures for this study were reviewed and approved by the Institutional Review Boards of the Shanghai Mental Health Center and other participating institutions. This study was performed in strict accordance with the Declaration of Helsinki and other relevant national and international regulations.

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Xu, F., Fan, W., Wang, W. et al. Effects of omega-3 fatty acids on metabolic syndrome in patients with schizophrenia: a 12-week randomized placebo-controlled trial. Psychopharmacology 236, 1273–1279 (2019). https://doi.org/10.1007/s00213-018-5136-9

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