20. Metabolic Abnormalities and Omega-3 Fatty Acids in Latinos at Clinical High Risk for Psychosis

Abstract

Background: Previous work has established a relationship between metabolic abnormalities and poorer health outcomes in individuals with schizophrenia spectrum disorders. It is likely that metabolic abnormalities, infammation, and oxidative stress observed in individuals with schizo‐phrenia actually begin to occur prior to the onset of psychosis and may potentially serve as a risk factor in populations at clinical high risk for developing psychosis. Further, in the general population, it has been estab‐lished that Latino individuals have a higher incidence of metabolic abnor‐malities than non‐Latinos, making CHR Latinos especially vulnerable to the compounded effects of pre‐existing metabolic disturbances with added risk of further metabolic disturbance associated with the development of psychosis. In a Clinical Trial of Omega 3 Fatty Acid versus Placebo, baseline cardiometabolic and oxidative stress indices were investigated in a group at Clinical High Risk (CHR) for psychosis from the North American Prodromal Longitudinal Studies (NAPLS). The goal of the present report was to compare cardiometabolic indices in Latino versus non‐Latino CHR subjects. Methods: Subjects met CHR criteria per the Structured Interview of Prodromal Syndromes (SIPS), received physical exams and metabolic mon‐itoring prior to randomization into the Omega 3 trial. Antipsychotic medi‐cation or history of diabetes were exclusions. Anthropometrical measures, vital signs, glucose, and lipids were assessed. RBC fatty acid composition was analyzed as a measure of dietary Omega‐3. Results: The sample included 127 CHR subjects (57.9% male) ages 12‐30 (Mean/SD = 18.5/4.6). Latino individuals comprise 82.5% of the sample and 66.7% of the subjects were white. Racial and ethnic groups did not differ signifcantly by age, sex, smoking history or antipsychotic exposure at baseline. Latinos subjects were more likely to have metabolic syndrome (F = 3.6, P =.016), higher levels of serum glucose (F = 7.7, P =.007), larger abdominal obesity (F= 9.29, P =.003), and have dyslipidemia (F = 4.23, P =.043). Latino subjects had signifcantly lower omega 3/6 ratio trans (F = 9.12, P =.003) and omega 3/6 ratio nontrans (F = 9.12, P =.003). Conclusion: Signifcant differences were found between Latino and non‐Latino CHR individuals, suggesting Latinos were more likely to suffer from metabolic abnormalities. These abnormalities were signifcantly associated with greater clinical symptoms and worse functional outcomes. Latino CHR individuals are a vulnerable minority that may suffer greater clinical and functional impairment. Special considerations should be given to this group especially if it is identifed that metabolic disturbances are predictive of transition to psychosis.