The role of the gut microbiome in weight-gain in schizophrenia patients treated with atypical antipsychotics: Evidence based on altered composition and function in a cross-sectional study

Objectives: We aimed to explore the interconnection between the weight-gain in schizophrenia patients with atypical antipsychotic treatment and gut microbiome. Methods: This study employed a cross-sectional design, encompassing a total of 88 schizophrenia patients with long-term atypical antipsychotic treatment. The 16S rRNA gene sequencing was used to identify gut microbiome contents. Results: No significant differences in alpha diversity between normal-weight and overweight schizophrenia treated with atypical antipsychotics. The beta diversity analysis showed that overweight patients clustered tightly while normal-weight patients clustered widely. For taxonomic composition, overweight patients had a lower relative abundance in Porphyromonadaceae at family level and Butyrivibrio at genus level, but higher relative abundance in Ruminococcus2 and Clostridium_XIVa at genus level than normal-weight patients. Function prediction revelated that four pathways (including Cell cycle, Non-homologous end-joining, Vibrio cholerae infection and Meiosis-yeast) were significantly different between groups. Correlation analysis indicated that Klebsiella, Butyrivibrio, Unassigned, Methanosphaera, Holdemania, Anaerotruncus were negatively, while Veillonella was positively correlated with BMI in patients. Conclusion: Our findings offer evidence that perturbations in the gut microbiome composition, encompassing taxa such as Porphyromonadaceae, Butyrivibrio, Ruminococcus2, and Clostridium_XIVa, in conjunction with distinct functional pathways including Cell cycle, Non-homologous end-joining, Vibrio cholerae infection, and Meiosisyeast, might contribute to the weight-gain in schizophrenia treated with atypical antipsychotics.

Automated summary

This study explored the relationship between weight gain in schizophrenia patients with atypical antipsychotic treatment and gut microbiome. The results showed that there were no significant differences in alpha diversity between normal-weight and overweight schizophrenia patients treated with atypical antipsychotics. However, the beta diversity analysis revealed distinct clustering patterns for overweight and normal-weight patients. The composition of the gut microbiome also differed between the two groups. Function prediction identified several pathways that were significantly different between groups. Correlation analysis indicated associations between specific bacteria and BMI. Overall, these findings suggest that perturbations in the gut microbiome composition and functional pathways may contribute to weight gain in schizophrenia patients treated with atypical antipsychotics.