The effect of stress and in vivo vasoactive intestinal peptide (VIP) treatment on the response of isolated rat aorta to norepinephrine, angiotensin II and vasopressin, and adventitial mast cells

The effects of cold-restraint stress, repeated over 3 days, and treatment of rats with vasoactive intestinal peptide (VIP) on the contractile responses of isolated aorta to vasoconstrictors, and on aortic adventitial mast cells were investigated. Stress significantly reduced the contractile response of rat aorta smooth muscle to norepinephrine (NE), angiotensin II (Ang II) and vasopressin (VP). Decreased sensitivity to NE, Ang II and VP may result from decreased receptor density, and affinity or reduced effector efficacy. Stress induced degranulation, decreased the number and changed the granular content of mast cells; all degranulated mast cells were stained with alcian blue, and the percentage of safranin staining cells was decreased. Given prior to stress, VIP reversed the reduced contractile responses and sensitivity of aorta to NE and Ang II but had no effect on VP subsensitivity. VIP also inhibited stress-induced degranulation of mast cells, and after VIP only alcian blue-stained mast cells were seen. When VIP was given to non-stressed rats, the contractile response of the aorta to NE, but not Ang II or VP, was increased compared with control. Mast cell count was decreased in the adventitia of non-stressed VIP treated rats. The results indicate that stress decreases the heparin content of mast cells and VIP has an additive effect. In conclusion, VIP modulates both stress-induced mast cell activity and reduced sensitivity of aorta smooth muscle to NE and Ang II. It can be suggested that VIP may moderate some effects of stress on vascular pathophysiology.     

Differential vascular adaptive response to stress exposure in male and female rats: role of gonadal hormones and endothelial cells

Although there are reports concerning a vascular adaptive response to stress in males, this is not yet defined in females. The aim of this study was to delineate functional gender differences in the rat vascular adaptive response to stress and to determine the ability of sex hormones to modulate the stress-induced vascular adaptive response. Responses to noradrenaline were evaluated in aortas, with and without endothelium, from intact, gonadectomized and gonadectomized-hormone-replaced males and females submitted or not to stress (2-h immobilization). Reactivity of the aorta of stressed and non-stressed intact males and females (n = 6-14 per group) was also examined in the presence of L-NAME or indomethacin. Stress decreased and gonadectomy increased maximal responses to noradrenaline in aortas with intact endothelium from both genders. Stress also reduced noradrenaline potency in males. In females, but not males, stress decreased the gonadectomy-induced noradrenaline hyper-reactivity to near that of intact non-stressed rats. Hormone replacement restored the gonadectomy-induced impaired vascular adaptive response to stress. L-NAME, but not indomethacin, abolished the stress-induced decrease in aorta reactivity of males and females. None of the procedures altered reactivity of aortas denuded of endothelium. CONCLUSION: Stress-induced vascular adaptive responses show gender differences. The magnitude of the adaptive response is dependent on testicular hormones and involves endothelial nitric oxide-system hyperactivity.     

Glucose metabolism,hippocampal subfields and cognition in first-episode and never-treated schizophrenia

BackgroundPrevious studies have indicated that glucose metabolism and altered hippocampal structure and function play a pivotal role in cognitive deficits in schizophrenia (SZ). This study was designed to explore the inter-relationship between glucose metabolism, hippocampal subfield volume, and cognitive function in the antipsychotics-naive first episode (ANFE) SZ patients.MethodsWe chose the fasting insulin, glucose, and insulin resistance (HOMA-IR) index as biomarkers of glucose metabolism. Cognitive function was assessed by the MATRICS Consensus Cognitive Battery (MCCB). The hippocampal subfield volume, glucose metabolism biomarkers, and cognitive function were evaluated in 43 ANFE SZ and 29 healthy controls (HCs).ResultsCompared with HCs, SZ patients had higher fasting blood glucose and insulin levels and HOMA-IR (all p < 0.05). Correlation analysis revealed that category fluency performance was positively associated with fasting glucose level. Fasting insulin or HOMA-IR was positively associated with the hippocampal subfield volume in patients (all p<0.05). Moreover, the spatial span index score was associated with the volume of the right presubiculum, subiculum, and right hippocampal tail. In addition, multiple regression analysis found that the interaction effects of insulin × right fimbria or insulin × left fimbria were independent predictors of the MCCB total score.ConclusionsOur findings suggest that abnormal glucose metabolism and cognitive decline occur in the early stage of SZ. The interaction between abnormal glucose metabolism and hippocampal subfields was associated with cognitive functions in SZ.     

血糖水平与急性脑梗死入院时神经功能的关系

为了观察血糖水平与急性脑梗死患者入院时神经功能的关系,我们对192例资料完整的首次发生急性脑梗死的患者进行临床研究。记录：年龄、性别、腰臀比、体重指数、血压、脑CT或MRI、空腹血糖、糖化血红蛋白、血脂、纤维蛋白原、C-反应蛋白、尿酸,入院时进行神经功能损伤评分。我们用欧洲卒中量表（ESS）、Barthel指数来评价脑梗死患者的神经功能。我们将血糖与ESS评分、Barthel指数纳入一元、多元线性回归分析。同时进行糖尿病组与非糖尿病组的梗死类型与梗死部位的比较。结果显示血糖水平与ESS评分、Barthel指数进行一元及多元线性回归分析,线性回归方程不成立。两组梗死类型及部位无差异性。结论为血糖水平与入院时患者神经功能损伤的严重程度无关。     

Effects of Feeding on Conditioned Avoidance Responses in Rats

Possible effects of feeding on learning were studied by comparing learned avoidance rates among three groups of Wistar rats that were given a diet at 1 h (1-h pretest group) and 5 h (5-h pretest group) before and immediately after (post-test group) the conditioned avoidance test. Learned avoidance rates during eight test sessions were higher in the order of the 1-h pretest, post-test, and 5-h pretest groups. This suggests that both pre- and post-test (training) feeding facilitates acquisition of conditioned avoidance learning presumably based on neurohumoral processes influenced by available plasma glucose concentrations.     

单纯糖耐量受损的冠心病患者临床及冠脉造影特点分析

入选空腹血糖正常并通过冠脉造影（CAG）确诊为冠心病（CAD）的患者104例行糖耐量试验（OGTT ）,将糖耐量正常（NGT ）者、单纯负荷后2h 血糖受损者（I-IGT ）与同期合并糖尿病（DM ）并通过 CAG 确诊为 CAD 的患者38例对照。结果,（1）DM 组甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（LDL-C）、载脂蛋白（Apo）、高敏-C 反应蛋白（hs-CRP）、尿微量白蛋白、尿酸（UA）高于 NGT 组（P＜0．05或 P＜0．01）,且 I-IGT 组体质量指数（BMI）最大,与 NGT组及 DM 组比较有统计学意义（P＜0．01）;（2）I-IGT 、DM 组冠状动脉病变支数、重度狭窄、闭塞、弥漫性病变、病变总积分、右冠状动脉病变比例均高于 NGT 组（P＜0．05或 P＜0．01）;（3）DM 组三支病变、弥漫性病变、冠状动脉病变总积分均高于 I-IGT 组（P＜0．05）。因此,空腹血糖正常的 CAD 患者均应行 OGTT 检查,以降低糖耐量异常的漏诊率;I-IGT 患者发生心血管疾病的危险性增加,且随着糖代谢异常的加重而加剧,应及早干预。     

Chronic stress and carbohydrate metabolism: persistent changes and slow return to normalcy in male albino rats

The present study tested the hypothesis that long-term repeated exposure to stressors results in irreversible changes in carbohydrate metabolism. Groups of adult male rats (five per group) were restrained for 1?h and 4?h later were forced to swim for 15?min everyday for 2, 4, or 24 weeks; five rats were autopsied after each interval. Groups of five rats exposed to stress for 2 or 4 weeks were maintained without further treatment (recovery groups) for up to 24 weeks. The fasting blood glucose concentration, measured at weekly intervals, was significantly higher in the stressed rats than in controls throughout the experiment, except in the 24th week, whereas that of the recovery groups was significantly higher than controls only up to the 8th week after the end of stress exposure and then reached normalcy. The blood concentrations of glucose, lactate, and pyruvate were significantly higher in the 2 and 4 weeks stress groups than in controls, whereas, except for lactate, in rats stressed for 24 weeks these values did not significantly differ from those in controls. These changes were accompanied by increased gluconeogenesis and glycogenolysis as shown by alterations in activities of hepatic carbohydrate metabolizing enzymes and unaltered blood insulin concentrations in rats stressed for 2, 4, and 24 weeks. Furthermore, the blood insulin levels did not significantly vary among controls and the 2, 4, and 24 weeks stress groups. The results reveal that though hyperglycemia induced by long-term stress exposure is reversible, it persists for a prolonged period, even after the termination of stress exposure, before reaching normalcy. Prevalence of hyperglycemia for a prolonged period through increased activities of hepatic enzymes in stressed rats exemplifies allostasis.     

FPG联合选择性OGTT模式在糖尿病筛查中的应用研究

探索空腹血糖(FPG)和选择性口服葡萄糖耐量试验(OGTT)相结合的糖尿病(DM)筛查模式。应用OGTT对无DM史人群行DM筛查,运用ROC曲线评价FPG对DM、IPH的诊断价值。FPG切点为7.0mmol/L时,诊断DM的敏感性为69%,特异性为100%;FPG切点为5.6mmol/L时,诊断IPH的敏感性为100%,特异性为83.3%。对FPG初筛在5.6mmol/L～6.9mmol/L者行OGTT,可在保证筛查准确性的基础上,最大程度节约成本。     

Motilin- and neuropeptide Y-like immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia.

BACKGROUND: The aim of the study was to compare plasma motilin-like immunoreactivity (MOT-LI) and neuropeptide Y (NPY)-like immunoreactivity (NPY-LI) in patients with functional dyspepsia (FD) during a controlled psychophysiological experiment. METHOD: 25 patients (12 men, 13 women), age 24-50, with recurrent FD, and 25 pair-wise sex- and age-matched community control subjects were studied. In an experiment, after a rest period, subjects were studied during a 15-min stress interview. The aim of the interview was to elicit anxiety. Before and during the intervention blood samples were drawn for peptide analyses. Outcome measures were the Gastrointestinal Symptom Rating Scale, fasting blood glucose, heart rate and blood pressure as well as the subjects' self-ratings on visual analogue scales. The plasma concentrations of MOT-LI and NPY-LI are given as anti-logarithms. RESULTS: Mean plasma MOT-LI concentration was 7.3 (CI: 5.7-9.4) pmol/L in the patient group, and 7.9 (CI: 6.1-10.2) pmol/L in the control group. Mean plasma NPY-LI concentration was 14.2 (CI: 12.3-16.4) pmol/L in the patient group, and 13.4 (Cl: 11.8-15.3) pmol/L in the control group. Using ANCOVA (covariates: group, gender, age, body mass index and smoking) MOT-LI was related to lower indigestion symptomatology (p<0.04) and positive change in joyfulness during the interview (p<0.03). In the patient group delta motilin correlated with increased joyfulness (p<0.03) and decreased sadness (p<0.03). The NPY-LI increase during the interview was related to higher fasting blood glucose before the interview (p<0.01) and a stronger increase in systolic blood pressure during the test (p<0.05). CONCLUSION: During a stress interview plasma MOT-LI is positively related to less indigestion symptomatology and joyfulness, while changes in plasma NPY-LI were positively related to sympathetic nervous system activity, but not to gastrointestinal symptoms.     

伴家族史的2型糖尿病危险因素的病例对照研究

为探讨2型糖尿病代谢特征及发病的危险因素,选取大连地区91例有家族史的T2DM患者为病例组,以44例患者的配偶（糖耐量正常）为对照组,进行流行病学问卷调查和体格检查,同时测定空腹血糖、空腹胰岛素、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白等指标,采用稳态模型法计算两组的胰岛素抵抗指数和β细胞功能指数,并进行多因素非条件Logistic回归分析。结果显示：TG、腰臀比和Ln（HOMAIR）病例组高于对照组,而Ln（HOMAβ）则病例组低于对照组,均具有统计学意义（P〈0．05）。多因素非条件Logistic回归分析结果提示,影响T2DM发病的因素有心血管疾病史、Ln（HOMAIR）及Ln（HOMAβ）。由此可见T2DM患者存在血脂代谢异常;心血管疾病史和Ln（HOMAIR）为发病的危险因素,Ln（HOMAβ）为保护因素。     

2型糖尿病一级亲属代谢相关指标分布规律的研究

为了研究2型糖尿病(DM)家系一级亲属的代谢相关指标变化规律,选择55个2型糖尿病家系中糖尿病患者的一级亲属为研究对象,按照糖耐量试验结果分组,比较组间血压、血糖、血脂、C肽、胰岛素等指标。结果显示,2型糖尿病家系一级亲属各组血脂水平的变化差异无显著性,而血糖、胰岛素抵抗等指标差异有显著性。由此得出结论,2型DM家系一级亲属血脂、血糖、血压、胰岛素等指标均有一定程度的异常,且各组间的血糖、血压、胰岛素抵抗等差异显著于血脂水平的变化。     

Does perceived exertion depend on glycemic index of foods ingested throughout three hours before a one-hour high-intensity exercise?

The purpose of this study was to assess the relationships between perceived exertion (RPE) and plasma glucose concentrations or hunger feelings during a 1-hr. bicycle submaximal exercise after ingestion of pre-exercise test foods with a different glycemic index. Each of endurance-trained male triathletes ingested three different glycemic index (GI) foods (HighGI: glucose, LowGI: whole-wheat biscuit or water) throughout the 3 hr. before exercise at 80% maximal oxygen uptake (VO2 max). RPE values increased as a logarithmic function of time. This result is opposite to results obtained with longer exercise bouts up to 3 hr. duration. RPE and hunger ratings were not significantly different for the three test foods whatever the time. Moreover, RPE did not correlate with plasma glucose concentrations during exercise. Consequently, RPE did not depend on the GI of the pre-exercise test foods during a 1-hr. exercise at 80% VO2 max. Physiological and psychological factors other than glycemic index may have mediated the perceptual responses during a 1-hr. high-intensity exercise. It is possible that during endurance exercise of longer duration, the level of blood glucose mediates the intensity of peripheral exertional perceptions arising from active skeletal muscle during prolonged exercise.     

Motilin-and neuropeptide Y-like immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia

Background  The aim of the study was to compare plasma motilin-like immunoreactivity (MOT-LI) and neuropeptide Y (NPY)-like immunoreactivity (NPY-LI) in patients with functional dyspepsia (FD) during a controlled psychophysiological experiment. Method  25 patients (12 men, 13 women), age 24–50, with recurrent FD, and 25 pair-wise sex- and age-matched community control subjects were studied. In an experiment, after a rest period, subjects were studied during a 15-min stress interview. The aim of the interview was to elicit anxiety. Before and during the intervention blood samples were drawn for peptide analyses. Outcome measures were the Gastrointestinal Symptom Rating Scale, fasting blood glucose, heart rate and blood pressure as well as the subjects’ self-ratings on visual analogue scales. The plasma concentrations of MOT-LI and NPY-LI are given as anti-logarithms. Results  Mean plasma MOT-LI concentration was 7.3 (CI: 5.7–9.4) pmol/L in the patient group, and 7.9 (CI: 6.1–10.2) pmol/L in the control group. Mean plasma NPY-LI concentration was 14.2 (CI: 12.3–16.4) pmol/L in the patient group, and 13.4 (CI: 11.8–15.3) pmol/L in the control group. Using ANCOVA (covariates: group, gender, age, body mass index and smoking) MOT-LI was related to lower indigestion symptomatology (p<0.04) and positive change in joyfulness during the interview (p<0.03). In the patient group delta motilin correlated with increased joyfulness (p<0.03) and decreased sadness (p<0.03). The NPY-LI increase during the interview was related to higher fasting blood glucose before the interview (p<0.01) and a stronger increase in systolic blood pressure during the test (p<0.05). Conclusion: During a stress interview plasma MOT-LI is positively related to less indigestion symptomatology and joyfulness, while changes in plasma NPY-LI were positively related to sympathetic nervous system activity, but not to gastrointestinal symptoms.     

The effects of training, epinephrine, and glucose injections on plasma glucose levels in rats

Recent findings indicate that a post-training injection of glucose enhances memory storage, suggesting that release of glucose into plasma may mediate the effects of epinephrine and perhaps other treatments on memory. The present experiment examined the effects of handling, inhibitory (passive) avoidance training, epinephrine and glucose injections on plasma glucose levels in Sprague-Dawley rats. Handling produced a small, but significant, transient increase in plasma glucose above basal levels. Saline injections caused a similar increase in circulating glucose levels. Inhibitory avoidance training with high footshock (2.0 mA, 2.0 s) resulted in significant increases in plasma glucose levels above those of low (0.5 mA, 0.75 s) and unshocked animals suggesting that glucose release is responsive to inhibitory avoidance training. Subcutaneous injections of epinephrine (0.01-1.0 mg/kg), or glucose (10-1000 mg/kg) significantly elevated glucose levels above those of saline-injected animals in a dose-dependent manner. Memory facilitating doses of epinephrine and glucose resulted in increases in plasma glucose levels similar to those seen in rats trained with high footshock. Higher doses of epinephrine and glucose resulted in further increases in circulating glucose, to levels significantly greater than those of memory facilitating doses. These results suggest that memory modulation, both endogenous and in response to epinephrine injections, may be mediated in part by circulating glucose levels. Thus, the findings of these experiments support the view that circulating glucose levels regulate the efficacy of neural memory storage processes.     

Rats (Rattus norvegicus) selectively bred to differ in avoidance behavior also differ in response to novelty stress, in glycemic conditioning, and in reward contrast

The behavior of the Syracuse high avoidance (SHA) and Syracuse low avoidance (SLA) rats, selectively bred by Brush (F. R. Brush, J. C. Froehlich, & P. Sakellaris, 1979, Behavior Genetics, 9, 309-316) to differ in avoidance behavior, was examined in several different tasks. The SLA rats showed a greater elevation in plasma glucose when exposed to a novel environment; after 7 days of exposure to this environment there was evidence of habituation in the SHA rats but not in the SLA rats; the SHA rats showed a hyperglycemic conditioned response in a glycemic conditioning procedure, the SLA rats showed no evidence of conditioning but had higher overall levels of plasma glucose; both strains showed reliable successive negative contrast effects in consummatory behavior when shifted from 32 to 4% sucrose, but the contrast was larger in the SLA rats; the administration of chlordiazepoxide eliminated negative contrast in the SLA rats but had no effect on contrast in the SHA rats; and the SLA rats were reliably heavier than the SHA rats. The behavioral differences were considered in the context of differences in emotional reactivity between the two strains.     

Vasopressin, glucose homeostasis, and sucrose taste preferences

Previous research indicates that vasopressin-containing (LE) rats are capable of adapting to the stress of food restriction, whereas vasopressin-deficient (DI) rats cannot adapt to this stressor. It has been postulated that abnormalities in glucose metabolism may be one of the factors leading to the demise of food-restricted DI rats. The present study was conducted to determine if taste preferences are altered in DI animals and if the presentation of exogenous glucose, in the form of sucrose solutions, can ameliorate the effects of the stress of food restriction. Four different concentrations of sucrose solutions were presented to LE and DI rats under the food-restricted condition. In both strains, an 8% sucrose solution was preferred over 0%, 16%, and 32% concentrations, with DI rats consuming more of this concentration than LE rats. Thus, when DI rats had the opportunity of maintaining glucose homeostasis by exogenous supplements, they maintained body weight, displayed no stomach pathology, and survived.     

Vasopressin,glucose homeostasis,and sucrose taste preferences

Previous research indicates that vasopressin-containing (LE) rats are capable of adapting to the stress of food restriction, whereas vasopressin-deficient (DI) rats cannot adapt to this stressor. It has been postulated that abnormalities in glucose metabolism may be one of the factors leading to the demise of food-restricted DI rats. The present study was conducted to determine if taste preferences are altered in DI animals and if the presentation of exogenous glucose, in the form of sucrose solutions, can ameliorate the effects of the stress of food restriction. Four different concentrations of sucrose solutions were presented to LE and DI rats under the food-restricted condition. In both strains, an 8% sucrose solution was preferred over 0%, 16%, and 32% concentrations, with DI rats consuming more of this concentration than LE rats. Thus, when DI rats had the opportunity of maintaining glucose homeostasis by exogenous supplements, they maintained body weight, displayed no stomach pathology, and survived.     

Neurotoxicity of Kainate to the Hippocampus is not Accrued by Aging, Stress and Exogenous Corticosterone in Wistar Kyoto and Spontaneously Hypertensive Rats

It has been reported that a high corticosterone milieu can exacerbate various experimental insults to the nervous system, in particular to the hippocampus. However, in many of these studies the above milieu was attained by injecting corticosterone in doses (e.g. 10 mg/rat) producing supraphysiological concentrations. In the present study we have investigated whether high plasma corticosterone levels, such as those associated with aging or stress, potentiate a hippocampal excitotoxic insult. Male Wistar Kyoto (WKY) and Spontaneously Hypertensive Rats (SHR) at the age of 6, 12, 18 and 24 months (only WKY for the oldest age) were used. As in other strains, aging in these rats was marked by an increase in basal plasma corticosterone levels. Rats were infused in the dorsal hippocampus with kainic acid (0.035 μg/hippocampus) and the neuronal injury was evaluated within the areas CA3 and CA4. Results indicated that neither aging nor the hypertensive condition affected kainic acid neurotoxicity. In order to study the effect of stress, rats were stressed twice a day, with alternate types of stressors to avoid possible habituation, 3 days prior to and 3 days following the kainic acid infusion. Using this experimental paradigm the hippocampal damage in stressed rats was of the same degree as in non-stressed controls. In a complementary set of experiments, 6 month old WKY and SHR rats were injected with corticosterone (10 mg/rat s.c.). Four hours after administration plasma corticosterone levels in the range of 60-70 μg/100 ml were found. Moreover, a time-course study showed a plasma corticosterone peak in the range of 240 μg/100 ml. Daily corticosterone administration for 3 days before and 3 days after kainic acid infusion potentiated the hippocampal damage in 6 months old SHR but not in the WKY. These results demonstrate that elevation of corticosterone levels within physiological range does not exacerbate hippocampal kainate neurotoxicity and that pharmacological doses of glucocorticoid hormone, which produces plasma levels well above those observable in any physiopathological condition, might, with some strain dependency, potentiate a hippocampal neurotoxic insult.     

Altered emotional and motivational processing in the transgenic rat model for Huntington's disease

Huntington disease (HD) is caused by an expansion of CAG repeat in the Huntingtin gene. Patients demonstrate a triad of motor, cognitive and psychiatric symptoms. A transgenic rat model (tgHD rats) carrying 51 CAG repeats demonstrate progressive striatal degeneration and polyglutamine aggregates in limbic structures. In this model, emotional function has only been investigated through anxiety studies. Our aim was to extend knowledge on emotional and motivational function in symptomatic tgHD rats. We subjected tgHD and wild-type rats to behavioral protocols testing motor, emotional, and motivational abilities. From 11 to 15 months of age, animals were tested in emotional perception of sucrose using taste reactivity, acquisition, extinction, and re-acquisition of discriminative Pavlovian fear conditioning as well as reactivity to changes in reinforcement values in a runway Pavlovian approach task. Motor tests detected the symptomatic status of tgHD animals from 11 months of age. In comparison to wild types, transgenic animals exhibited emotional blunting of hedonic perception for intermediate sucrose concentration. Moreover, we found emotional alterations with better learning and re-acquisition of discriminative fear conditioning due to a higher level of conditioned fear to aversive stimuli, and hyper-reactivity to a negative hedonic shift in reinforcement value interpreted in term of greater frustration. Neuropathological assessment in the same animals showed a selective shrinkage of the central nucleus of the amygdala. Our results showing emotional blunting and hypersensitivity to negative emotional situations in symptomatic tgHD animals extend the face validity of this model regarding neuropsychiatric symptoms as seen in manifest HD patients, and suggest that some of these symptoms may be related to amygdala dysfunction.     

Metabolic and endocrine disturbances in psychiatric disorders: a multidisciplinary approach to appropriate atypical antipsychotic utilization

Patients with psychiatric disorders have an increased rate of cardiovascular morbidity and mortality compared with the general population. Metabolic issues such as weight gain, dyslipidemia, diabetes mellitus, diabetic ketoacidosis,and pancreatitis have been reported with the use of antipsychotic agents. Although atypical antipsychotics have not been linked directly to the development of metabolic syndrome, these medications have been shown to increase risk factors that can lead to metabolic and endocrine disturbances. Therefore, clinicians should provide ongoing monitoring for patients who are being treated for psychiatric disorders with these agents. According to the 2004 Consensus Report on Antipsychotics, screening measures should include baseline and follow-up monitoring of personal/family histories, weight (body mass index), waist circumference, blood pressure, fasting plasma glucose, and fasting lipid profile.