Comparison of metabolic parameters and Framingham cardiovascular risk scores before and after in‐hospital treatment with antipsychotics

Abstract

SummaryBackground. The objective of this naturalistic study was to evaluate changes in the prevalence of metabolic syndrome (MetS) and Framingham cardiovascular risk scores in adult with schizophrenia after inhospital treatment with antipsychotics. Methods. For 58 patients (36 women and 22 men) the following data was acquired on admission and at discharge: body height and weight, waist circumference, cigarette smoking, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides (TGA), fasting plasma glucose (FPG), blood pressure, concomitant use of antidiabetic, antihypertensive and antihyperlipidemic medications. results. Mean TGA levels increased significantly (140.32 mg/dL vs. 180.17 mg/dL), other parameters did not change. MetS prevalence on admission and at discharge did not differ significantly, irrespective of definition used (IDF: 50.00% vs. 60.34%; ATPIII: 39.66% vs. 43.10%; ATPIII A: 46.55% vs. 51.72%). Two cardiovascular risk scores were reduced at discharge: stroke, 10-year (4.10% vs. 3.46%) and hypertension, 4-year (22.18% vs. 16.58%). Other Framingham risk scores did not change. Very high prevalence of abnormal body weight (up to 65%), abdominal obesity (63% in men and 89% in women), hypertension (>50%) and lipid abnormalities (31-64%) was found. Conclusions. We have found a very high rate of MetS in patients treated with antipsychotics. No metabolic parameters improved after hospital stay, while some worsened. This did not, however, result in increased risk of cardiovascular events. Abnormal body weight and lipid abnormalities were very common in our study population. Our results indicate that metabolic parameters should be monitored regularly, particularly in outpatient settings, and appropriate treatment should be introduced as soon as any signifand appropriate treatment should be introduced as soon as any significant changes are found.

Multilocus Genetic Profile Reflecting Low Dopaminergic Signaling Is Directly Associated with Obesity and Cardiometabolic Disorders Due to Antipsychotic Treatment

“…On the other hand, we observed that BMI was associated with the illness duration, being higher in those patients with fewer years of illness and SGA treatment, agreeing with other studies indicating that the critical period for developing obesity and alterations in other cardiometabolic disorder parameters is within the first 18 months of treatment [ 14 , 76 , 77 ]. In addition, we found that abdominal obesity was higher in women than in men in accordance with previous studies [ 78 ]. Regarding DBP, we showed that DBP levels were related to age, being higher in those patients with older age [ 79 ].…”

Lipid and Glucose Profile across Different Mental Disorders

“…The average HDL level was mostly high in the schizophrenia group, where the differences between diagnostic group levels were not statistically significant. For the schizophrenia group, the mean HDL level was highest (58.76 mg/dL) compared to four other studies [6,7,9,10] (45.3 mg/Dl, 49.3 mg/dL, 43.7 mg/dL, and 51.1 mg/dL, respectively). The prevalence of low HDL was the highest (65.77%) among men with unipolar depression compared to the other lipid categories, which is in contrast to the results of [6], which showed that the prevalence was 59.70% among men with bipolar depression.…”

“…The average TGA level was mostly high in the bipolar depression group compared to other groups. For the schizophrenia group, the mean TGA level was the lowest (133.10 mg/dL) compared to four other studies [6,7,10,11], which were 139.8 mg/dL, 192.4 mg/dL, 159.1 mg/dL, and 162.6 mg/dL. Also, for the schizophrenia group, the high TGA level was higher (33.20%) compared to 32.80% in [6] and lower compared to 42.30% in [12].…”

“…The average level of TC was mostly high in the bipolar depression group compared to other groups. For the schizophrenia group, the average TC level was 174.51 mg/dL, which was lower than [6,7,9,10], which were 188.5 mg/dL, 204.9 mg/dL, 204.3 mg/dL, and 185.0 mg/dL, respectively. High TC level prevalence was higher in women than men, where it was the lowest in bipolar mania (16.85%) and the highest in bipolar depression (44.30%), similar to [6].…”

“…The average FPG level was mostly high in the bipolar disorder group compared to other groups. For the schizophrenia group, the average FPG level was 90.23 mg/dL, lower than [6,10], which had values of 95.8 mg/dL and 94.8 mg/dL, respectively. Moreover, for the schizophrenia group, the prevalence of high FPG was 26.00%, slightly higher than [12] at 25.30% and lower than [6] at 29.70%.…”