Acute psychotic stress is associated with decreased adiponectin serum levels

Objective: To determine the effect of acute psychotic stress on adipokine secretion in non-diabetic subjects. Research design and methods: Adiponectin, leptin, and cortisol serum levels were determined in 39 non-diabetic patients with acute psychotic stress reaction admitted to a psychiatric ward. The clinical global impression (CGI) score was used to evaluate the level of psychotic stress. Insulin sensitivity (IS) was determined by the homeostasis model assessment (HOMA). Patients were re-assessed 2 weeks after admission. During hospitalization patients were treated for variable times with either phenothiazines or thioxanthenes. Results: The mean CGI score decreased significantly with time: 5.3 +/- 0.8 and 2.6 +/- 0.8 on admission and after 2 weeks respectively (p < 0.001). On admission, the mean adiponectin level was significantly lower in patients compared to normal controls: 15.3 +/- 8.2 mu g/ml and 26 +/- 12.8 mu g/ml, respectively (p=0.02). It increased significantly after 2 weeks to 18.2 +/- 10 mu g/ml (p=0.003). By contrast, the leptin and cortisol levels did not change significantly. No correlation was found between the changes in individual CGI scores and adiponectin levels. However, female patients with the highest stress on admission demonstrated the lowest adiponectin levels and insulin sensitivity: p=0.002 and 0.03 respectively. Conclusions: These data suggest a link between acute psychotic stress reaction and decreased serum adiponectin levels. Further studies are recommended to determine the strength of this association.