The Prevalence of Metabolic Syndrome in Schizophrenic Patients Using Antipsychotics

Abstract

Objective: To examine the prevalence of metabolic syndrome and its risk factors in a large group of schizophrenic patients. Methods: Sociodemographic and treatment data were collected from medical records of 1,103 inpatients and outpatients treated for schizophrenia at Seoul National Hospital in Seoul, Korea. Anthropometric measurement and blood testing were conducted for collection of physical and biochemical data and diagnosis of metabolic syndrome. Data for metabolic syndrome prevalence were compared by sex, age, metabolic syndrome markers present, treatment of markers, and types of antipsychotics and individual drug agents used. Results: Mean prevalence of metabolic syndrome in all subjects was 43.9% and 40.1% according to adapted Adult Treatment Panel III (ATP-IIIa) and International Diabetes Federation criteria, respectively. No significant differences were found in prevalence according to ATP-IIIa criteria between men (42.6%) and woman (45.9%). A trend toward higher prevalence with age was observed for both sexes until 50 years, followed by a continued increase for women but a decrease for men. Use of a combination of atypical antipsychotics was associated with the highest metabolic syndrome prevalence and use of aripiprazole with the lowest. High percentages of subjects with hypertension and dyslipidemia were not being treated for these conditions. Conclusion: Despite their higher prevalence in schizophrenic patients, metabolic syndrome and its markers are not being adequately managed in these patients. Treatment of schizophrenic patients requires attention to not only their psychiatric conditions but also associated medical conditions by individual health care practitioners and hospitals as well as the public health care sector as a whole.

Proteomic Characterization of the Brain and Cerebrospinal Fluid of Schizophrenia Patients

“…Previous data demonstrated the role of glucose administration in attenuating deficits in verbal declarative memory [22] in agreement with other studies demonstrating a relation between glucose regulation and memory performance [22,23]. Those suffering from schizophrenia have a tendency to develop the metabolic syndrome, which comprises type 2 diabetes mellitus, dyslipidemia and hypertension, all representing medical conditions that increase intra-abdominal fat deposition and are in a way also controlled by cortisol levels [24]. Evidence indicates that drug-naïve or drug-free schizophrenia patients present higher levels of plasma cortisol, which indicates an imbalance in the hypothalamic-pituitary-adrenal axis and also increased levels of corticotropin-releasing hormone in CSF samples [25]; however, some other studies do not show significant increases in cortisol levels [26].…”

Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials

“…They are rapidly becoming a favorite first choice for this indication, mainly due to their low propensity to cause extrapyramidal adverse effects and favorable efficacy in ameliorating both positive and negative symptoms 1). Some studies have, however, shown that these novel compounds are associated with metabolic abnormalities characterized by hyperglycemia, dyslipidemia, and an increased risk of diabetes mellitus 2,3). Metabolic syndrome is characterized by the symptoms of central obesity, insulin resistance, atherogenic dyslipidemia, hypertension, ischemic heart disease (IHD), and overall mortality 4,5).…”

The common pathophysiology underlying the metabolic syndrome, schizophrenia and depression. A review

“…Therefore, vulnerability factors for development of schizophrenia, diabetes, and MetS seem to be shared and interconnected. In patients with schizophrenia the risk is further greatly increased by the use of antipsychotic medication as reviewed repeatedly elsewhere 8,[51][52][53][54][55] . More specifically, elevated blood levels of adiponectin have been reported in schizophrenia 56 and there is a correlation between serum leptin levels and body weight 51 .…”