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P626 Inflammatory markers of antipsychotic weight gain and cardiometabolic dysfunction in youth mental health disorders

Introduction Second generation antipsychotics (SGAs) are prescribed to treat mental health disorders in children. However, there are concerns about these medications due to cardiometabolic side effects including weight gain with a risk of Type 2 Diabetes Mellitus. There is limited understanding of the factors increasing susceptibility to these side effects. It is established that increased adiposity associated with weight gain is mediated by the emergence of a persistent low-grade inflammatory state. However, there has been no research investigating the relationships between pro-inflammatory states in children and the cardiometabolic side-effects of SGAs and there are no clinical indicators of those at risk. Aims To determine whether there is a subgroup of patients at baseline who present with a profile of immune dysregulation. To investigate how SGA medication impacts on inflammatory markers and cardiometabolic function in children. To investigate the potential to predict those at greater risk of developing adverse metabolic outcomes in response to the treatment with SGAs. Methods We are recruiting children and adolescents (5-18 years) who are commencing SGA medication. We assess the cardiometabolic profile clinically and biochemically and obtain serum and peripheral blood mononuclear cells (PBMCs) to measure levels of inflammatory markers. Through comparison with biobanked healthy control samples, we will determine if there is a subgroup at baseline with a pro-inflammatory profile. The patient groups are assessed longitudinally at 3, 6 and 12 months to measure BMI percentile and cardiometabolic function. Changes in immune cells and inflammatory markers are measured including IL-1, IL-10, IL-17, sCD-163, TNF-α and IFN-γ as well as leptin, ghrelin and adiponectin in response to treatment with antipsychotics. Results Twelve patients have been recruited and are being followed up longitudinally. Of the data analysis that has been completed, it appears that leptin and TNF-α levels have increased in the participants with the most weight gain (6–9 kg) between baseline and 3 months after commencing SGAs. Discussion Identification of a high-risk group for weight gain is vitally important and it would allow clinicians to work with these patients to minimise the metabolic side effects of the medications; through rational SGA choice, promotion of intensive monitoring and implementation of preventative treatment regimes. Antipsychotic use is a prominent cause of obesity in young people with mental health disorders. Through this study, we aim to modify clinical practice, which we hope will lead to better guidelines to reduce the risks.