A simple screening tool for metabolic syndrome risk in the psychiatric patient treated with antipsychotic medication

Abstract

Objective: This study sought to determine whether waist to height ratio (WhtR) can be used to identify psychiatric patients at risk for metabolic syndrome (MetS). Body mass index (BMI) is most often used as the primary determinant for MetS in current screening protocols. There is currently no defined range of values of BMI that determine the level of risk. Psychiatric patients have twice the risk of dying from cardiovascular events than the general population. Cardiovascular disease has been a consequence of metabolic dysregulation that is common to MetS which involves abnormalities in at least three of the following biometric parameters: increase waist circumference, decreased high density lipids (HDL), increased triglycerides (TRG), elevated fasting blood sugar (FBS) and elevated blood pressure (BP). It is well documented that antipsychotic medication is a risk factor for developing MetS.Methods: A retrospective record review (n = 48), evaluated the clinic records of psychiatric patients treated with antipsychotic medication. Data from these records compared the relationship between the WhtR and BMI. The association between WhtR and BMI was analyzed through a Pearson correlation analysis and their respectively sensitivity and specificity for predicting risk for MetS was analyzed using a Receiver Operating Characteristic (ROC) curve. Confounding of the relationships between WhtR and risk of MetS by other risk factors was examined using generalized linear models.Results: Pearson coefficients of BMI and WhtR revealed a strong positive correlation r = 0.935, p = .01. Furthermore, WhtR was evaluated utilizing a ROC curve and demonstrated maximum sensitivity between 0.52 and 0.58 with the maximum specificity at 78%. Both WhtR and BMI showed robust measures in determining metabolic syndrome risk. The relationship between WhtR and risk of MetS existed even when controlling for other factors. Conclusions:The ratio of waist circumference to height, can provide a reliable low-cost, non-invasive form of measurement that can be performed in any setting, to monitor the progression of metabolic involvement.

Indexing adult obesity by waist-to-height and weight-to-height ratios

“…The reported success of WCHR [3,15,17,38] is in many respects explained by inadequacies of BMI 2 . Firstly, WCHR varies less than BMI 2 , given an individual.…”

“…[16,38] Evidently, T2DM is linked to obesity much closer than HT or CVD. One of the earlier mentioned reviews [3] estimated the optimal WCHR value for predicting T2DM in adults, derived from a selection of studies, as 0.56 for non-Asians (0.51 for Asians).…”

Prevalence of metabolic syndrome and associated factors among psychiatric patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

“…The data was collected through face-to-face interviews and hospital files of the patients using data collection instruments and measuring essential parameters from the patients. The data collection instrument was adapted from the previous studies [ 12 , 15 , 16 ], and it includes sections focusing on socio-demographic, other baseline characteristics, and clinical characteristics. WhtR was calculated by dividing waist circumference (in inches) by height (in inches).…”