The incidence of metabolic syndrome and its reversal in a cohort of schizophrenic patients followed for one year

Abstract

Cross-sectional studies showed a high prevalence of metabolic syndrome in patients with schizophrenia.This study aimed to identify the incidence of metabolic syndrome and its reversal in a non-preselected cohort of chronic psychotic patients in routine practice in one year follow-up and to find variables to describe development and reversal of metabolic syndrome. This cohort study was conducted as part of a disease management program and patients were included if they had two complete assessments in a one year follow-up. We conducted two logistic regressions to find variables to describe the development of metabolic syndrome and the reversal of metabolic syndrome. At the time of the first assessment 35% (n=92) of the 260 included patients had metabolic syndrome. Within one year 21 patients developed metabolic syndrome and 30 patients had it reversed. This was an incidence of 13% (21/168) and a reversal of 33% (30/92). Smoking, family history of cardiovascular diseases, and duration of disease >6 years was associated with a higher risk of developing metabolic syndrome as well as abdominal obesity and dyslipidemia. Patients with abdominal obesity had a smaller chance of reversing metabolic syndrome. Other variables included in the logistic regression such as receiving cardiovascular/antidiabetic drug treatment or duration of disease >6 years did not alter the risk of reversing the metabolic syndrome. Our study showed that the natural course of metabolic syndrome is dynamic. A considerable number of patients developed or reversed the metabolic syndrome in one year follow-up.

Cardiometabolic comorbidity in antipsychotic treated patients: need for systematic evaluation and treatment

“…The observation that cardiometabolic parameters may normalize over a period of one year, suggests a dynamic course, which is in line with other reports (L ' Italien et al 2007;Srisurapanont et al 2007;Schorr et al 2009). This finding stresses the importance of accurate monitoring with repeated measurements before confirming a diagnosis and initiating treatment.…”

Risk Factors for Overweight and Diabetes mellitus in Residential Psychiatric Patients

“…The existence of a direct relationship is also supported by other evidence [7]. Psychiatric patients are prone to develop the metabolic syndrome [8]. This is partly due to the influence of atypical anti-psychotic medication, which is associated with the development of overweight, dyslipidemia, and diabetes mellitus type 2 [9].…”

Prevalence of Metabolic Syndrome in Patients with Schizophrenia in Korea: A Multicenter Nationwide Cross-Sectional Study

“…The prevalence of MetS in patients with schizophrenia varies across studies: 35.4% in the Netherlands,14 32.3% in Belgium,15 40.9% in the United States CATIE study,12 22.8% in Thailand,16 27.5% in Japan,17 and 31.7% in Korea 13…”

“…The causes of this variety in the prevalence include the use of different definitions of MetS, such as that of the Adult Treatment Panel III report (ATP III) of the National Cholesterol Education Program,1214 the modified ATP III,131517 and the International Diabetes Federation (IDF) 16. In addition, some studies of Asian patients used Asian or Korean criteria for abdominal obesity.…”