To investigate whether the rate of weight gain is associated with cardiometabolic risk, independent of weight measured concurrently.
Healthy 7–17 year-old risperidone-treated patients (n=105, 88% male) had blood pressure, anthropometry, and laboratory tests performed. Growth history was extracted from medical records. The rate of change in age-sex-adjusted weight and body mass index (BMI) z-score after the initiation of risperidone was individually modeled. Multivariable linear regression analyses explored the association of the rate of weight (BMI) z score change with cardiometabolic outcomes, independent of last measured weight (BMI) z score.
Following a mean of 1.9 years (sd=1.0) of risperidone treatment, the absolute increase in weight and BMI z-scores was 0.61 (sd=0.61) and 0.62 (sd=0.73), respectively. After controlling for the final weight z-score, the rate of change in weight z-score was significantly associated with final glucose (p<0.04), C-peptide (p<0.004), HOMA-IR (p<0.02), HDL cholesterol (p<0.0001), a metabolic syndrome score (p<0.005), adiponectin (p<0.04), and hsCRP (p<0.04). After controlling for the final BMI z-score, the rate of change in BMI z-score was associated with final HDL cholesterol (p<0.04), leptin (p<0.03), and adiponectin (p<0.04), with a suggestion of an association with final HOMA-IR (p<0.08).
The rate of weight gain in risperidone-treated children explains equally or more of the variance in certain cardiometabolic outcomes (e.g., HDL cholesterol: ΔR2= 11% vs. ΔR2= 8% and hsCRP: ΔR2= 9% vs. ΔR2= 5%) than the weight measured concurrently, and may serve as a treatment target.