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Beta-carotene and Oxidative Stress in Pediatric Second Generation Antipsychotic Use

Withdrawn
Conditions
Pediatric Population on Second Generation Antipsychotics
Registration Number
NCT02363816
Lead Sponsor
Wayne State University
Brief Summary

Weight gain, hypertension, high cholesterol and sugar abnormalities in childhood are strongly linked and predict the risk of further complications and early death in adulthood. The newer antipsychotics, called the second generation antipsychotics are commonly used to treat mood disorders in adult and pediatric populations. Their use has substantially increased (up to 5-fold) in the past 15 years in children due to their approved use by the Food and Drug Administration and higher acceptance in the general medical community. However, second generation antipsychotics are known to have very damaging side effects that cause children to gain substantial amounts of weight, have high cholesterol, high blood pressure and high sugar levels. Despite the known risks their use is still needed and may be contributing to the high rates of obesity-related diseases in childhood and ultimately shorter life-spans in adulthood. How second generation antipsychotics cause these side effects is still not well known. Preliminary evidence has identified a novel pathway that may be associated with second generation antipsychotic side effects. This pathway has not been studied, is involved in vitamin A metabolism and is called the beta-carotene pathway. Beta-carotene is an important part of our diet because it acts as an anti-oxidant (fights harmful oxidative stress in the body) and it produces the active form of vitamin A which is essential for several processes in our body. The investigator's work has identified a backup in this pathway which the investigators hypothesize is due to genetic variation of the enzymes found within this pathway.

The investigators hypothesize that genetic variation in the beta-carotene pathway is responsible for the side effects associated with second generation antipsychotics. The investigators want to complete a cross-sectional, pilot study in the pediatric population that will be used for future prospective, extramural applications.

The investigators propose two aims for this study:

Aim 1: Determine how second generation antipsychotics change beta-carotene metabolism. For this aim, the investigators hypothesize that high beta-carotene:retinoic acid ratios will be due to genetic varition in the beta-carotene pathway.

Aim 2: Define the relationship between beta-carotene metabolism, oxidative stress and second generation antipsychotic induced insulin resistance. For this aim the investigators hypothesize that low beta-carotene levels will be associated with high oxidative stress levels and insulin resistance.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  1. Children aged 10 to 17 years currently treated with one or more antipsychotics as determined by a physician
  2. No changes in antipsychotic dosage for the past 6 weeks.
Exclusion Criteria
  1. Guardian or child unwilling or unable to participate.
  2. A diagnosis of diabetes or dyslipidemia prior to starting an antipsychotic.
  3. Abuse or dependence diagnoses

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
retinoic acid levelsmeasured during cross-sectional visit

serum level reported in nmol/L

beta-carotene levelsmeasured during cross-sectional visit

serum level reported in mcg/dL

Secondary Outcome Measures
NameTimeMethod
F2 Isoprostanesmeasured during cross-sectional visit

peripheral biomaker of oxidative stress determined by ELISA in pg/ml

Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)measured during cross-sectional visit

Calculated by the following equation: \[fasting insulin (pIU/mL) × fasting blood glucose (mmol/L)\]/22.5

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