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Physical capacity, respiratory quotient and energy expenditure during exercise in male patients with schizophrenia compared with healthy controls
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Perinatal, neonatal och barnkardiologisk forskning/Jonzon)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
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2012 (English)In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 27, no 3, p. 206-212Article in journal (Refereed) Published
Abstract [en]

BACKGROUND

Despite massive research on weight gain and metabolic complications in schizophrenia there are few studies on energy expenditure and no current data on physical capacity. AIM: To determine oxygen uptake capacity, respiratory quotient (RQ) and energy expenditure during a submaximal exercise test in patients with schizophrenia and healthy controls.

METHOD

Ten male patients and 10 controls were included. RQ and energy expenditure were investigated with indirect calorimetry during a cycle ergometer test. The submaximal work level was defined by heart rate and perceived exhaustion. Physical capacity was determined from predicted maximal oxygen uptake capacity (VO(2-max)).

RESULTS

The patients exhibited significantly higher RQ on submaximal workloads and lower physical capacity. A significant lower calculated VO(2-max) remained after correction for body weight and fat free mass (FFM). Energy expenditure did not differ on fixed workloads.

CONCLUSION

RQ was rapidly increasing in the patients during exercise indicating a faster transition to carbohydrate oxidation and anaerobic metabolism that also implies a performance closer to maximal oxygen uptake even at submaximal loads. This may restrict the capacity for everyday activity and exercise and thus contribute to the risk for weight gain. Physical capacity was consequently significantly lower in the patients.

Place, publisher, year, edition, pages
2012. Vol. 27, no 3, p. 206-212
Keyword [en]
Schizophrenia, Physical capacity, Respiratory quotient, Oxygen uptakecapacity, Energy expenditure, Body weight
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-138990DOI: 10.1016/j.eurpsy.2010.06.007ISI: 000302516500008PubMedID: 20970966OAI: oai:DiVA.org:uu-138990DiVA, id: diva2:380538
Available from: 2010-12-21 Created: 2010-12-21 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Physiological Aberrations in Patients with Schizophrenia
Open this publication in new window or tab >>Physiological Aberrations in Patients with Schizophrenia
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In schizophrenia, subtle aberrations in the brain cause functional disturbances like psychotic symptoms and social disability. There are, however, also disturbances outside the CNS indicating a systemic manifestation in the disease. The aim of the present thesis was to gain deeper understanding of the pathophysiological mechanisms underlying schizophrenia with a particular interest in peripheral and systemic manifestations with relevance for the increased risk of obesity and metabolic complications seen in the disease. Therefore, resting energy expenditure (REE), physical capacity, and relevant body composition variables were measured in patients with schizophrenia and in healthy controls. Also niacin skin flush response and electrodermal activity (EDA) were studied.

Patients with schizophrenia exhibited significantly lower REE expressed as kJ/kg, and also lower values compared with predicted levels than the controls. The difference could not be attributed to medication or variations in body composition between the two groups. There was a gender difference with the lowest levels found in male patients.

Male patients exhibited significantly lower physical capacity in terms of predicted maximal oxygen uptake capacity and faster increase in respiratory quotient than male controls.

The oral niacin test revealed a significantly delayed skin flush reaction in patients compared with controls. The patients also exhibited lower EDA response. There was a significant association in response patterns for the niacin and the EDA tests in the patients, but not in controls.

In a test-retest study in patients there was acceptable stability for EDA measures but low test-retest stability for niacin variables. The previously found association in responses for the two tests was, however, replicated.

The results gain support for the concept of schizophrenia as a disease with systemic manifestations including metabolic dysregulation. The findings add to the understanding of the weight gain and the increased risk for cardiovascular morbidity seen in this condition.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. p. 86
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 413
Keyword
Schizophrenia, resting energy expenditure, body composition, physical capacity, oxygen uptake capacity, respiratory quotient, niacin, skin flush reaction, electrodermal activity
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-9521 (URN)978-91-554-7388-4 (ISBN)
Public defence
2009-01-31, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2009-01-01 Created: 2009-01-01 Last updated: 2012-05-09Bibliographically approved

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Nilsson, Björn MikaelOlsson, Roger M.Ekselius, LisaForslund, Anders H.

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