Is abnormal non-high-density lipoprotein cholesterol a gender-specific predictor for metabolic syndrome in patients with schizophrenia taking second-generation antipsychotics?

Abstract

Evidence supports an association between metabolic syndrome (MetS) and schizophrenia. However, specific risk factors for MetS and gender differences in patients with schizophrenia taking second-generation antipsychotics (SGAs) have not been well explored. A cross-sectional cohort of 329 Han Chinese patients was recruited in a psychiatric hospital in central Taiwan. Using the definitions of the International Diabetes Federation for Chinese, the prevalence of MetS was 23.7% (men: 25.7%; women: 21.2%). Logistic regression analyses showed that patients with a BMI ≥ 24 and an abnormal non-high-density lipoprotein cholesterol (non-HDL-C) were significantly (p < 0.001) more likely to develop MetS. A BMI ≥ 24 was a significant risk factor in men (OR: 6.092, p < 0.001) and women (OR: 5.886, p < 0.001). An abnormal non-HDL-C was a significant specific risk factor for men with MetS (OR: 4.127, p < 0.001), but not for women. This study supports a greater prevalence of MetS in patients with schizophrenia taking SGAs than in the general population. Abnormal BMI and non-HDL-C were significantly associated with developing MetS, and an abnormal non-HDL-C was a specific risk factor for men. Future development of specific interventions and regular monitoring for MetS is imperative for early identification and prevention.

The prevalence of metabolic syndrome in patients receiving antipsychotics in Qatar: a cross sectional comparative study

“…In this group, regression analysis showed obesity as a risk factor to develop MetS. A study on Han Chinese patients with schizophrenia had also demonstrated high BMI as an independent risk factor to develop MetS [ 40 ]. Similar findings were reported in a prospective study on patients with bipolar disorder from Italy where older age, higher BMI and exposure to antipsychotics were independently associated with the risk of developing MetS after two years [ 41 ].…”

“…It is worth noting that the majority of the population in Qatar is men (75%) as many workers migrate to Qatar without their families. However, the studies from other countries reported mixed results in regard to gender [ 21 , 35 , 40 ]. Furthermore, our study also showed that being of non-Arab origin was a risk factor for developing MetS.…”

Risk Factors of Metabolic Syndrome Among Patients Receiving Antipsychotics: A Retrospective Study

“…It is challenging to control for all these confounders, but some studies attempted to look at the various demographic and clinical variables that might be associated with metabolic abnormalities. Such studies have shown that women tend to show more weight gain on AP (Bener et al 2014;Gates et al 2016;Santini et al 2016) than men but other studies showed mixed results in regard to gender (Hammoudeh et al 2018;Lin et al 2015;Susce et al 2005). Concerning ethnicity, a previous study from Qatar showed that non-Arabs were more prone to develop metabolic changes in the population of Qatar (Hammoudeh et al 2018), but other community studies worldwide showed no differences across race or ethnicity (Gates et al 2016;Phillips et al 2015).…”

Latent Toxoplasma gondii infection is associated with decreased serum triglyceride to high-density lipoprotein cholesterol ratio in male patients with schizophrenia

“…Only male patients were enrolled in the study in order to exclude the influence of gender on the results. Notably, gender differences were reported in metabolic issues, such as obesity [12], lipid levels [13], the prevalence of MetS [14], and treatment-outcome [15] in patients with schizophrenia. Patients were evaluated using structured interview for the Positive and Negative Symptom Scale (PANSS) [16], including the PANSS positive, negative, general psychopathology and cognitive (PANSS-COGN) subscale (consisting of P2, N5, N7, G7, G10, G11, G12, G14 and G15 PANSS items), as well as with Calgary Depression Scale for Schizophrenia (CDSS) [17] and International Suicide Prevention Trial (InterSePT) Scale [18].…”