Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya

Abstract

Background A high prevalence of metabolic syndrome and its components in patients with psychotic disorders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work in this field has emerged from low-resourced contexts. This study investigated the prevalence, correlates, and treatment patterns of metabolic disorders in patients with psychotic disorders in Western Kenya. Methods 300 patients with psychosis and 300 controls were recruited at Moi Teaching and Referral Hospital in Eldoret, Kenya. Data on demographic characteristics, weight, height, abdominal circumference, blood pressure, blood glucose, lipid profile, and treatments were collected. Categorical and continuous data were compared between the patient and control groups using Pearson’s chi-squared tests and t-tests, respectively. Variables found to be significantly different between these groups were included in logistic regression models to determine potential predictors of metabolic syndrome. Results Compared to controls, patients with psychosis were found to have a higher mean random blood glucose [5.23 vs 4.79, p = 0.003], higher body mass index [5.23 vs 4.79, p = 0.001], higher triglycerides [1.98 vs 1.56, p<0.001], larger waist circumference [89.23 vs 86.39, p = 0.009] and lower high density lipoprotein [1.22 vs 1.32, p<0.001]. The odds of developing metabolic syndrome were increased with age [OR = 1.05, CI: 1.02–1.07] and presence of a psychotic disorder [OR = 2.09 [CI 1.23–3.55]; and were reduced with female gender [OR 0.41, CI 0.25–0.67], among those who were never married [OR 0.52, CI 0.28–0.94] and among the widowed/separated/ divorced marital status [OR 0.38, CI 0.17–0.81]. While the majority of patients received treatment with olanzapine, there was no association between olanzapine use and metabolic syndrome and its components. More than half of the patients in this study sample were not receiving treatment for the various components of metabolic syndrome. Conclusion In the study setting of Eldoret, metabolic syndrome and its components were more prevalent among patients with psychotic disorders than in controls; and a clear treatment gap for these disorders was evident. There is a need for efforts to ensure adequate screening and treatment for these physical disorders in resource-limited settings.

Optimization of Early Diagnosis of Glucose Metabolism Impairment for Patients Receiving Antipsychotic Medications at the Outpatient Psychiatric Clinic of the University Teaching Hospital, Lusaka, Zambia

“…Although females were more likely to have a higher percentage of overweight than males, statistically, this was not significant. This finding does differ from the one that was found in a study done by Kwobah and colleagues, which showed that 45% of the patients with a psychiatric disorder were obese as compared to normal individuals who were not suffering from psychotic disorders [40]. In terms of waist circumferences, 42.2% of the study population had higher waist circumferences.…”

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study

“…Notably, 56.2% of medical service patients do not undergo medical monitoring, nor are they evaluated by a psychiatrist during service. This therapeutic inertia has already been described by other groups [ 34 , 35 ].…”

Prevalence of metabolic syndrome among patients with schizophrenia in Ethiopia

“…For instance, in a study carried out in South Africa on 278 subjects with severe mental illness, the estimated prevalence of MetS was 23.2% [ 31 ]; whereas, in the middle belt of Ghana 14.1% [ 32 ]. The report from Kenya was slightly higher at 28.6% [ 33 ]. Three studies conducted in the central, south, and western part of the Ethiopia among patients with psychiatric illness, diagnosed with schizophrenia, major depressive disorder, bipolar disorder and others, reported prevalence of MetS ranged from 18 to 25% [ 14 – 16 ].…”