Increased Silent Brain Infarction Accompanied With High Prevalence of Diabetes and Dyslipidemia in Psychiatric Inpatients

Kanzaki, Tetsuto; Uju, Yoriyasu; Sekine, Keisuke; Ishii, Yukihiro; Yoshimi, T; Yasui, Reiko; Yasukawa, Asuka; Sato, M.; Okamoto, Seiko; Hisaoka, Tetsuya; Miura, Masafumi; Kusanishi, Shun; Murakami, Kanako; Nakano, Chieko; Mizuta, Yasuhiko; Mimori, Seisuke; Mishima, Shunichi; Igarashi, Kazuei; Takizawa, Tsuyoshi; Hayakawa, Tatsuro; Tsukada, Kazumi

doi:10.4088/pcc.14m01713

Cited by 7 publications

(7 citation statements)

References 41 publications

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“…In the current study, higher distribution of patients with abnormal levels of HDL, triglycerides, hsCRP, and blood pressure were diagnosed with SBIs. The association of these risk factors with SBIs was not statistically significant, which contrasts with the results of the similar studies on SBIs (18) . Similar results with respect to levels of triglycerides and low HDL levels in association with SBI was also reported by Kato et al (19) .…”

Section: Discussioncontrasting

confidence: 56%

Silent Brain Infarcts in Patients with Non-Specific Neurological Symptoms: 1-Year Cross-Sectional Study

Pakalapati¹

2018

jmscr

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Section: Discussioncontrasting

confidence: 56%

Silent Brain Infarcts in Patients with Non-Specific Neurological Symptoms: 1-Year Cross-Sectional Study

Pakalapati¹

2018

jmscr

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“…Saku et al [12] and Kondo S et al [3] reported that the standardized mortality rate of schizophrenic patients with vascular diseases was higher than in the general population in Japan, but they did not show that the precise nature of vascular diseases. Recently, our study has shown that psychiatric inpatients have increased silent brain infarction (SBI) and cerebral infarctions compared with Japanese healthy controls, accompanied with high prevalence of diabetes and low HDL-cholesterolemia [13]. These results suggest that cerebral incidents are also important in quality of life in psychiatric patients of Japan.…”

Section: Introductionmentioning

confidence: 75%

“…Psychiatric patients of our previous study were hospitalized patients who were diagnosed as schizophrenic group 69.1%, mood disorders group 18.4% and others 12.5% [13]. Schizophrenia and mood disorders are primary psychiatric diseases, whose symptoms and treatment medicines are dissimilar.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study on metabolic similarities and differences between inpatients with schizophrenia and those with mood disorders

Uju

Kanzaki

Yamasaki

et al. 2020

Preprint

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Background One of the main causes of death in psychiatric patients is cardiovascular diseases which are closely related with lifestyle-related diseases. Psychiatric disorders include schizophrenia and mood disorders, whose symptoms and treatment medicines are different, suggesting that they might have different metabolic disorders. Thus, we studied the differences of lifestyle-related diseases between schizophrenia and mood disorders in Japan. Methods This cross-sectional study was performed from 2015 to 2017. Study participants were 189 hospitalized patients (144 schizophrenia group, 45 mood disorders group) in the department of psychiatry at Kohnodai hospital. We examined physical disorders, metabolic status of glucose and lipid, estimated glomerular filtration rate (eGFR) and brain magnetic resonance imaging. We compared these data between inpatients with schizophrenia or mood disorders group and the standard. We quoted ‘The National Health and Nutrition Survey in Japan 2015’ by Ministry of Health, Labor and Welfare as the standard. In comparisons between schizophrenia and mood disorders groups, we used analysis of covariance or logistic regression analysis. Results The ratio of silent brain infarction (SBI) and cerebral infarction were significantly high in both groups compared with the standard. Schizophrenia group showed significantly higher prevalence of diabetes, low high-density lipoprotein (HDL) cholesterolemia, metabolic syndrome and smoking than the standard. Mood disorders group had significantly high prevalence of low HDL-cholesterolemia compared with the standard. Fasting blood glucose and HbA1c were significantly higher in schizophrenia group and female mood disorders group than the standard. Female mood disorders group had significantly decreased eGFR with increased ratio of eGFR < 60 ml/min than the standard. In comparison between both groups, eGFR and prevalence of smoking in mood disorders group were significantly lower than those in schizophrenia group by adjustment for age. Conclusions Participants of both groups had increased ratio of SBI and cerebral infarction, accompanied with glucose and lipid disorders. Distinct from schizophrenia group, mood disorders group showed significantly lower eGFR and prevalence of smoking.

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“…In patients with psychosis, the residual atherogenic risk may also be relevant with respect to reducing silent brain infarcts. 42 Standard CVD risk algorithms may inaccurately estimate the CVD risk in schizophrenia, 43,44 and models specific to this mental illness have recently been developed. 45 Other factors which may contribute to cardiovascular risk, but which are less well understood, include the clear evidence of systemic inflammation in schizophrenia, 46 and the fact that patients with schizophrenia are prothrombotic.…”

Section: Discussionmentioning

confidence: 99%

“…These studies were not specific to patients with schizophrenia, but may be relevant to patients with this mental illness and warrant further research. In patients with psychosis, the residual atherogenic risk may also be relevant with respect to reducing silent brain infarcts 42 . Standard CVD risk algorithms may inaccurately estimate the CVD risk in schizophrenia, 43 , 44 and models specific to this mental illness have recently been developed 45 .…”

Section: Risk Factors For Cvd In Patients With Schizophreniamentioning

confidence: 99%

Cardiovascular disease in patients with schizophrenia

Kritharides

Chow

Lambert

2017

Medical Journal of Australia

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Patients with schizophrenia die on average 25 years earlier than the general population, and this gap appears to be increasing. Most of the excess mortality is due to premature cardiovascular deaths rather than suicide. Many psychotropic agents are orexigenic and can increase weight and promote dyslipidaemia. Traditional cardiac risk factors are undertreated among patients with schizophrenia, and they are less likely to receive cardiac revascularisation than those without a mental illness. Clozapine is an atypical antipsychotic medication effective for treatment of refractory schizophrenia, but is associated with the risk of myocarditis and cardiomyopathy. Established protocols in Australia screen for myocarditis for patients who are initiating clozapine therapy and for long term monitoring for cardiomyopathy with echocardiography. Coordinated care between tertiary providers, general practitioners and primary health care professionals should monitor the physical health of people with psychosis or schizophrenia at least annually and treatment should be offered accordingly.

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Increased Silent Brain Infarction Accompanied With High Prevalence of Diabetes and Dyslipidemia in Psychiatric Inpatients

Abstract: Participants in this study had an increased ratio of silent brain infarction compared with Japanese healthy controls, accompanied with higher ratios of diabetes and low HDL cholesterol.

Cited by 7 publications

References 41 publications

Silent Brain Infarcts in Patients with Non-Specific Neurological Symptoms: 1-Year Cross-Sectional Study

Silent Brain Infarcts in Patients with Non-Specific Neurological Symptoms: 1-Year Cross-Sectional Study

A cross-sectional study on metabolic similarities and differences between inpatients with schizophrenia and those with mood disorders

Cardiovascular disease in patients with schizophrenia

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