<p>Prevalence and Associated Factors of Metabolic Syndrome Among Patients with Severe Mental Illness at Hawassa, Southern-Ethiopia</p>

Abstract

Background: Patients with severe mental disorders have a high risk of metabolic-related complications like metabolic syndrome (MetS), diabetes mellitus (DM), hypertension and lipid derangements, and these factors may predispose them to a high mortality rate. Data is very scarce regarding MetS among patients with severe mental illness in Ethiopia. Therefore, this study aimed to assess the prevalence of MetS and its associated factors among patients with severe mental illness. Methods: A cross-sectional study was conducted in Hawassa University Comprehensive Specialized Hospital from January to June 2019 among adult patients attending a psychiatric outpatient department, Southern Ethiopia. A systematic random sampling technique was used to select 245 study subjects. Socio-demographic and other data were collected using a structured questionnaire. Both the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) guidelines were used to define MetS. Results: The prevalence of MetS was 24.5% and 26.9% by NCEP-ATP and IDF criteria respectively. In both definitions, females had significantly higher MetS when compared to males (31.4% vs 19.6%; p=0.03 by NCEP), and (34.3% vs 21.7%; p =0.03 by IDF), respectively. Duration >5 years with mental illness indicated higher MetS when compared to duration ≤ 5 years (42.9% vs 19.9%, p=0.001; and 46.9% vs 21.9%, p<0.0001) in NCEP and IDF, respectively. In addition, marital status [AOR (95% CI): 2.4 (1.1-5.3)], and BMI [AOR (95% CI): 8.4(4.0-17.6)], duration > 5 years with mental illness [AOR (95% CI): 2.8 (1.2-6.5)], and age >40 years [AOR (95% CI): 2.7(1.2-6.1)] were significantly associated factors of MetS by NCEP. While BMI, age >40 years and duration > 5 years with mental illness were associated with MetS by IDF. Conclusion: Long-time experience with severe mental illness and antipsychotic therapy might predispose patients to metabolic complications with significant risks of cardiovascular events. Therefore, intensive screening of patients for MetS/components is required during follow-up based on national non-communicable diseases guideline. Besides, the proper intervention of patients concerning lifestyle changes and averting risk full behaviors is mandatory.

Metabolic syndrome and associated factors among severely ill psychiatric and non-psychiatric patients: a comparative cross-sectional study in Eastern Ethiopia

“…In addition, the present study revealed that participants of female sex were at higher risk of developing metabolic syndrome than those of male participants (AOR: 7.4, CI: 2.0, 27.6, p < 0.05). This result is consistent with the studies conducted in Kashmir [ 29 ], South Africa [ 46 ], South West Ethiopis [ 21 ] and Southern-Ethiopia [ 31 ]. Possible explanations for this gender disparity include differences in physiology, level of physical activity, and psychological factors between the male and female sexes.…”

“…Adipose tissue possibly secretes many cytokines and reactive oxygen radicals, thus promoting inflammation and insulin resistance syndrome [ 44 , 49 , 50 ]. This finding was in line with the studies conducted in Southern Ethiopia [ 31 ] and Venezuela [ 51 ] ever alcohol intake was significantly associated with metabolic syndrome. However, this finding was in contrast with the study conducted in Jimma that found alcohol intake was not associated with metabolic syndrome [ 21 ].We speculate the difference could be due to the time variation, the socio-economic and cultural factors observed between the study participants.…”

“…The overall prevalence of metabolic syndrome among psychiatric patients in the current study was (35.6%) comparable with different studies: 28.9% at Jimma University Medical Center, Ethiopia [ 21 ], 34.74% in Kashmir [ 29 ] and 43.6% in Palestine [ 30 ]. However, the prevalence estimated in the present study was much higher than in studies conducted in Hawassa, 24.5% [ 31 ], 23.51% in Uganda [ 15 ], and 24.3% in Brazil [ 32 ]. The possible difference could be due to differences in types or generation of antipsychotic agents used by the patients (in our study, most of the patients used first-generation antipsychotics at the time of study), period of study, patients’ lifestyle, patterns of psychiatric illness (in our study, patients with severe psychiatric disorder were considered), duration of psychiatric illness, and sociocultural differences [ 33 – 35 ].…”

The Prevalence of Metabolic Syndrome in Ethiopian Population: A Systematic Review and Meta-analysis

“…The prevalence of MetS was estimated based on the IDF and NCEP/ATPIII criteria among the Ethiopian population of various study subjects. Fourteen studies reported the prevalence of MetS based on both IDF and NCEP/ATPIII criteria [ 36 – 44 , 48 – 50 , 54 , 56 ], seven studies based on NCEP/ATPIII criteria only [ 57 – 63 ], and again seven studies by IDF criteria only [ 45 – 47 , 51 – 53 , 55 ]. Table 3 presents the characteristics and outcomes of the reviewed studies.…”

Metabolic syndrome among people with mental illness in sub Saharan Africa: Female gender as a factor. A Systematic review and meta-analysis

“…All the included nine studies were cross sectional studies in their design. These studies were conducted across different countries of sub-Saharan Africa (two primary articles from Ethiopia [ 16 , 17 ], three from South Africa [ [18] , [19] , [20] ], two studies from Nigeria [ 21 , 22 ] and the rest two were from Ghana [ 23 ] and Uganda [ 24 ]. The sample size of primary studies included in this review was considerably variable ranging 88 to 450 participants ( Table 2 ).…”