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Hu S, Liu X, Zhang Y, Ma J. Prevalence of metabolic syndrome and its associated factors in first-treatment drug-naïve schizophrenia patients: A large-scale cross-sectional study. Early Interv Psychiatry 2024. [PMID: 38778369 DOI: 10.1111/eip.13565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Metabolic syndrome (MetS), a condition that includes several risk factors specific for cardiovascular disease, is commonly detected among patients with schizophrenia (SCZ). This study elucidated the factors contributing to the development and severity of MetS in first-treatment drug-naïve (FTDN) patients with SCZ. METHODS The study enrolled 668 individuals with FTDN SCZ, aged 18-49 years, who had no exposure to antipsychotic medications and been hospitalized between February 2017 and June 2022 at the largest psychiatric specialty institution in central China. Patient sociodemographic and general clinical data were collected, and their psychopathology scores and illness severity were assessed using the Positive and Negative Symptom Scale (PANSS) and Clinical Global Impression Scale-Severity of Illness (CGI-SI), respectively. MetS score was calculated to determine the disease severity. RESULTS The prevalence of MetS among this study population was 10.93%. Binary logistic regression analysis revealed onset age, female sex, total cholesterol, and red blood and white blood cell counts as risk factors for MetS, and deemed free tetraiodothyronine (FT4) and CGI-SI score as protective factors. Multiple linear regression analysis result confirmed older SCZ onset age as a risk factor for elevated MetS score. CONCLUSION This study determined the prevalence of MetS in patients with FTDN SCZ and revealed the factors that influence the occurrence and severity of the disease. These findings will allow development of specific prevention and treatment strategies in clinical practice.
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Affiliation(s)
- Suoya Hu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Xuebing Liu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yanting Zhang
- Department of Psychiatry, Suzhou Guangji Hospital, Suzhou, China
| | - Jun Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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Akinola PS, Tardif I, Leclerc J. Antipsychotic-Induced Metabolic Syndrome: A Review. Metab Syndr Relat Disord 2023; 21:294-305. [PMID: 37347965 DOI: 10.1089/met.2023.0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Schizophrenia, a serious psychiatric disorder, is among the top 10 global causes of disability and affects nearly 1% of the world population. Antipsychotics constitute the best treatment for patients with schizophrenia, however, this treatment class carries a high risk of metabolic syndrome, including lipid abnormalities. Indeed, the risk of metabolic syndrome would be increased in the population with schizophrenia compared to the general population. The objective is to summarize the prevalence, the mechanisms, and the potential treatments of antipsychotic-induced metabolic syndrome. This is a narrative review of the literature. We searched the electronic database Medline, accessed through PubMed, to find studies that investigated the prevalence and treatments of metabolic syndrome in the adult population using antipsychotics. The prevalence of metabolic syndrome in patients treated with antipsychotics ranges from 37% to 63%. Antipsychotic iatrogenic effects include weight gain/increased waist circumference, dyslipidemia, insulin resistance/type 2 diabetes, and hypertension. Clozapine and olanzapine are reported to precipitate the onset of metabolic syndrome features. In patients with metabolic syndrome, an antipsychotic with less metabolic side effects such as lurasidone, lumateperone, ziprasidone, and aripiprazole should be prioritized. Unlike medications, aerobic exercise and dietetic counseling were found to be efficient as the nonpharmacologic treatment of antipsychotic-induced metabolic syndrome. Few pharmacological treatments were proven effective against weight gain in this patient population. The risk of metabolic syndrome induced by antipsychotics should be early recognized and closely monitored. Primary and secondary prevention of metabolic syndrome or onset of its feature might help reduce the risk of death for patients using antipsychotics.
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Affiliation(s)
- Pelumi Samuel Akinola
- College of Pharmacy, Rady Faculty of Health sciences, University of Manitoba, Winnipeg, Canada
| | | | - Jacinthe Leclerc
- Faculté de Pharmacie, Université Laval, Québec, Canada
- Centre de Recherche, Institut Universitaire de Cardiologie de Pneumologie de Québec-Université Laval, Québec, Canada
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Abidi O, Vercherin P, Massoubre C, Bois C. [The global cardiovascular risk of patients with schizophrenia hospitalized in psychiatry at the university hospital of Saint-Étienne]. Encephale 2019; 45:200-206. [PMID: 31178036 DOI: 10.1016/j.encep.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 06/25/2018] [Accepted: 06/29/2018] [Indexed: 02/02/2023]
Abstract
CONTEXT Patients suffering from schizophrenia present with a risk of cardiovascular death which is two to three times as high as the general population. OBJECTIVES Our study aims to evaluate the global cardiovascular risk according to SCORE and Framingham on patients suffering from schizophrenia who have been hospitalized in psychiatric institutions and also to assess whether being under the care of a physician affects that risk. METHODS A prospective descriptive epidemiologic study was conducted from April 2005 to March 2016. The study population consisted of adult patients suffering from schizophrenia who were hospitalized in the psychiatric unit of the CHU de Saint-Étienne. The data was collected during the clinical admission examination. The software CARDIORISK was used to compute the global cardiovascular risk according to SCORE and Framingham. RESULTS The average cardiovascular risk was about four times as high for males as it was for females according to the SCORE model and twice as high according to the Framingham model. According to the SCORE model, 16.5 % of the patients presented a high cardiovascular risk versus 6.6 % according to the Framingham model. There was no statistically significant difference between patients who were under the care of a physician and those who were not, both in terms of the prevalence of the risk factors and in terms of the global cardiovascular risk. CONCLUSION Using the global cardiovascular risk approach as a primary prevention measure could allow patients suffering from schizophrenia to be admitted earlier. Also, regularly reevaluating that risk could allow initiation of behavioral changes and/or important cardiovascular treatments.
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Affiliation(s)
- O Abidi
- Service médecine générale, 3 rue du Dr Gallavardin, 69800 Saint-Priest-en-Jarez, France.
| | - P Vercherin
- Service de santé publique, CHU de Saint-Étienne, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | - C Massoubre
- Service de la psychiatrie, CHU de Saint-Étienne, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | - C Bois
- Service médecine générale, 3 rue du Dr Gallavardin, 69800 Saint-Priest-en-Jarez, France
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Masa-Font R, Fernández-San-Martín MI, Martín López LM, Alba Muñoz AM, Oller Canet S, Martín Royo J, San Emeterio Echevarría L, Olona Tabueña N, Ibarra Jato M, Barroso García A, González Tejón S, Tajada Vitales C, Díaz Mújica B, Viñas Cabrera L, Sanchís Catalán R, Salvador Barbarroja T. The effectiveness of a program of physical activity and diet to modify cardiovascular risk factors in patients with severe mental illness after 3-month follow-up: CAPiCOR randomized clinical trial. Eur Psychiatry 2015; 30:1028-36. [PMID: 26521223 DOI: 10.1016/j.eurpsy.2015.09.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 09/05/2015] [Accepted: 09/05/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of this randomized clinical trial follow-up at three months was to evaluate the effectiveness of an educational intervention with a focus on diet and physical activity (PA) to change the amount of PA, body mass index (BMI) and the waist circumference (WC) in patients with severe mental illness. METHODS We recruited 332 outpatients with severe mental disorders undergoing treatment with antipsychotic medication from Mental Healthcare Centers of Barcelona. They were randomly assigned to an intervention or a control group. The patients in the intervention group participated in a group PA and diet educational program. The blinded measurements at 0 and 3 months were: the level of PA (IPAQ questionnaire), BMI, WC, blood pressure, dietary habits (PREDIMED questionnaire), quality of life (SF-36 questionnaire) and laboratory parameters (cholesterol, triglycerides, glucose). RESULTS The average age was 46.7 years and 55% were males. Schizophrenia had been diagnosed in 67.1% of them. At 3 months, the average weekly walking METs rose significantly in the IG 266.05 METs (95%CI: 16.86 to 515.25; P=0.036). The total MET average also rose although not significantly: 191.38 METs (95%CI: 1.38 to 381.38; P=0.086). However, the BMI decreased significantly more in the CG, by 0.26kg/m(2) (95%CI: 0.02 to 0.51; P=0.038), than in the IG. There were no significant differences in the WC. CONCLUSIONS The short-term results suggest that the intervention increases the level of PA, but does not improve physical or laboratory parameters. TRIAL REGISTRATION Clinicaltrials.gov NCT01729650 (effectiveness of a physical activity and diet program in patients with psychotic disorder [CAPiCOR]).
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Affiliation(s)
- R Masa-Font
- EAP Besòs, Institut Català de la Salut (ICS), C/Alfons el Magnànim 57, 08019 Barcelona, Spain.
| | | | - L M Martín López
- Centre Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar Hospital del Mar, Passeig Marítím, 25-29, 08003 Barcelona, Spain
| | - A M Alba Muñoz
- Centre Salut Mental Ciutat Vella, Parc Sanitari Sant Joan de Déu, C/Via Laietana 19, 08003 Barcelona, Spain
| | - S Oller Canet
- Centre Salut Mental Martí i Juliá (INAD), C/President Lluís Companys 8, 08921 Santa Coloma de Gramenet, Spain
| | - J Martín Royo
- CUAP Casernes (ICS), C/Fernando Pessoa 47-51, 08030 Barcelona, Spain
| | | | - N Olona Tabueña
- Àmbit d'Atenció Primària Barcelona Ciutat, Unitat d'Avaluació, Sistemes d'Informació i Qualitat, C/Numància 23, Barcelona, Spain
| | - M Ibarra Jato
- Centre Salut Mental Sant Martí Nord (INAD), Pl Infància, s/n, 08020 Barcelona, Spain
| | | | | | - C Tajada Vitales
- EAP Doctor Vilaseca (Can Mariner), C/Sant Carles 79, 08921 Santa Coloma de Gramenet, Spain
| | - B Díaz Mújica
- Centre Salut Mental Sant Martí Sud (INAD), Passeig Marítim 25-29, 08003 Barcelona, Spain
| | - L Viñas Cabrera
- EAP Poblenou (ICS), C/Lope de Vega 138, 08005 Barcelona, Spain
| | - R Sanchís Catalán
- Centre Salut Mental Sant Martí Sud (INAD), Passeig Marítim 25-29, 08003 Barcelona, Spain
| | - T Salvador Barbarroja
- Centre Salut Mental Sant Martí Nord (INAD), Pl Infància, s/n, 08020 Barcelona, Spain
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Vetter MW, Martin BJ, Fung M, Pajevic M, Anderson TJ, Raedler TJ. Microvascular dysfunction in schizophrenia: a case-control study. NPJ SCHIZOPHRENIA 2015; 1:15023. [PMID: 27336034 PMCID: PMC4849449 DOI: 10.1038/npjschz.2015.23] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 05/05/2015] [Accepted: 05/13/2015] [Indexed: 12/11/2022]
Abstract
Background: Schizophrenia is a mental illness associated with cardiovascular disease at a younger age than in the general population. Endothelial dysfunction has predictive value for future cardiovascular events; however, the impact of a diagnosis of schizophrenia on this marker is unknown. Aims: We tested the hypothesis that subjects with schizophrenia have impaired endothelial function. Methods: A total of 102 subjects (34.5±7.5 years) participated in this study. This sample consisted of 51 subjects with a diagnosis of schizophrenia and 51 healthy subjects, who were matched for age (P=0.442), sex (P>0.999), and smoking status (P=0.842). Peripheral artery microvascular and conduit vessel endothelial function was measured using hyperemic velocity time integral (VTI), pulse arterial tonometry (PAT), and flow-mediated dilation (FMD). Results: Significantly lower values of VTI were noted in subjects with schizophrenia (104.9±33.0 vs. 129.1±33.8 cm, P<0.001), whereas FMD (P=0.933) and PAT (P=0.862) did not differ between the two groups. A multivariable-linear-regression analysis, built on data from univariate and partial correlations, showed that only schizophrenia, sex, lipid-lowering medications, antihypertensive medications, and low-density lipoprotein (LDL)-cholesterol were predictive of attenuated VTI, whereas age, ethnicity, family history of cardiovascular disease, smoking status, systolic blood pressure, waist circumference, HDL-cholesterol, triglycerides, C-reactive protein, and homeostatic model assessment-insulin resistance (HOMA-IR), antidiabetic medications, antidepressant medications, mood stabilizers, benzodiazepines, and anticholinergic medications did not predict VTI in this model (adjusted R2=0.248). Conclusions: Our findings suggest that a diagnosis of schizophrenia is associated with impaired microvascular function as indicated by lower values of VTI, irrespective of many other clinical characteristics. It might be an early indicator of cardiovascular risk in schizophrenia, and might help to identify high-risk individuals.
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Affiliation(s)
- Martin W Vetter
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgery, AB, Canada; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Billie-Jean Martin
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada
| | - Marinda Fung
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada
| | - Milada Pajevic
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada
| | - Todd J Anderson
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada
| | - Thomas J Raedler
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgery, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgery, AB, Canada
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