Latin American Clinical Epidemiology Network Series – Paper 1: The Latin American Clinical Epidemiology Network “LatinCLEN”

High prevalence of metabolic alterations in Latin American patients at initial stages of psychosis

AIM

Studies conducted in the United States have highlighted a higher prevalence of metabolic alterations (MA) in Latino population and Latino psychotic patients. Metabolic risk in psychosis is known to be present from initial stages of the disease. To better characterize this population, we explored the prevalence of MA and metabolic syndrome (MS) in early psychosis patients in a Latin American country.

METHODS

Transversal, observational study comparing the prevalence of MA and MS in patients with early psychosis from an outpatient program in Chile (n = 148) with a community representative sample from the 2009-2010 National Health Survey (n = 568). ANOVA and regression analysis were performed obtaining odds ratio for MA and MS.

RESULTS

The prevalence of MS was 44.7% in patients compared to 11.4% in the community sample (odds ratio [OR] 5.28, confidence interval [CI] 95% 3.07-9.08; P-value <0.001). There was no effect of gender. Subgroup analyses showed no significant association of MS with clozapine/olanzapine use, treatment duration or tobacco use. There was an association between treatment duration and hypertriglyceridemia (P = 0.024; OR 1.02, CI 95% 1.00-1.04) and obesity (P = 0.007; OR 5.93, CI 95% 1.82-20.22). Clozapine/olanzapine use was associated with hyperglycaemia (P = 0.007; OR 6.04, CI 95% 1.63-22.38) and high low density lipoprotein (P = 0.033 ANOVA; OR 5.28, CI 95% 1.14-24.37).

CONCLUSION

Latino psychotic patients have a high risk of MA and MS at initial stages of the disease which is not entirely explained by the higher risk in the whole Latino population, is irrespective of gender, and does not seem to be entirely a response to atypical antipsychotic use.