High Prevalence of Obesity, Hypertension, Hyperlipidemia, and Diabetes Mellitus in Japanese Outpatients with Schizophrenia: A Nationwide Survey

Abstract

BackgroundPatients with schizophrenia have significantly shorter life expectancy than the general population, and a problem they commonly face is an unhealthy lifestyle, which can lead to obesity and metabolic syndrome. There is a very clear need to determine the prevalence of obesity, hypertension, hyperlipidemia, and diabetes mellitus which are components of metabolic syndrome in patients with schizophrenia, but there has been a paucity of large-scale studies examining this situation in Japan. The aim of our study was to address this need.Setting & ParticipantsWe conducted a large-scale investigation of the prevalence of obesity, hypertension, hyperlipidemia, and diabetes mellitus using a questionnaire in 520 outpatient facilities and 247 inpatient facilities of the Japan Psychiatric Hospitals Association between January 2012 and July 2013. There were 7,655 outpatients and 15,461 inpatients with schizophrenia.ResultsThe outpatients had significantly higher prevalence of obesity, hypertension, hypertriglyceridemia, hyper-LDL cholesterolemia, and diabetes mellitus than the inpatients. The prevalence of hypo-HDL cholesterolemia was higher in inpatients than outpatients. Age-specific analysis showed the prevalence of obesity, hypertension, hypertriglyceridemia, hyper-LDL cholesterolemia, and diabetes mellitus among outpatients to be 2- to 3-fold higher than among inpatients. In individuals aged ≥60 years, the prevalence of obesity and DM among outpatients was about 3-fold higher than among inpatients.ConclusionJapanese outpatients with schizophrenia were more likely to have physical risk such as obesity, hypertension, hyperlipidemia, and diabetes mellitus than inpatients. The physical risk to patients with schizophrenia may be affected by environmental parameters, such as type of care. The physical risk to Japanese patients with schizophrenia demands greater attention.

Schizophrenia and type 2 diabetes mellitus

“…The comorbidity between schizophrenia and increased prevalence of type 2 diabetes mellitus is well established in many different studies on clinical samples, 1,2 attributed to lifestyle habits and medications, as well as gene-environment interaction factors and shared susceptibility genetic loci for schizophrenia and type 2 diabetes mellitus.…”

Schizophrenia and COVID-19: risks and recommendations

“…5 More than 70% of all schizophrenia patients also have one or more clinical conditions, 6 including diabetes type II, 7,8 pulmonary chronic disease, 9 and hypertension/coronary heart disease. 10,11 Smoking estimates among schizophrenia patients vary from 50 to 90%, 12 compared to 20-30% in the general population, and involve higher smoking intensity, another potential risk factor for respiratory complications, 13 although it is not yet clear whether COVID-19 outcomes are worse among smokers. 14 Spirometric assessment indicates that schizophrenia patients have impaired lung function, and they are more often diagnosed with restrictive and obstructive pulmonary diseases.…”

Lipid-lowering and antioxidative effects ofApium graveolensL. root flavonoid extracts

“…HLP is the direct cause of coronary heart disease, 1 artherosclerosis, 2 acute pancreatitis, 3 cirrhosis, 4 gallstones, 5 peripheral vascular diseases, 6 hyperuricemia, 7 hypertension and diabetes. [8][9][10] In addition, the high levels of TC, TG and LDL-C in the HLP patients result in disorders of lipid metabolism, one of the major causes of oxidative stress wherein the rate of production of reactive oxygen species (ROS) exceeds their clearance rate. Since the liver is both the main source and target of ROS, HLP is also a key inducer of non-alcoholic fatty liver disease (NAFLD).…”