The prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia

Li, Qiongzhen; Du, Xiangdong; Zhang, Yingyang; Yin, Guiqin; Zhang, Guangya; Walss‐Bass, Consuelo; Quevedo, Joao L De; Soares, Jair C.; Xia, Haishen; Li, Xiaosi; Zheng, Yingjun; Ning, Yuping; Zhang, Xiang Y

doi:10.1016/j.psychres.2016.12.041

Cited by 42 publications

(39 citation statements)

References 39 publications

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“…Obesity is a common comorbidity in schizophrenia, with higher prevalence than the general population. 16 Even in first-episode schizophrenia, 22% of the patients were overweighed in a study conducted with 2548 patients. 17 Another study showed that patients diagnosed with schizophrenia were overweight-obese (45-55%, RR: 1.5-2), smokers (50-80%, RR: 2-3), had diabetes (10-15%, RR: 2), hypertension (19-58%, RR: 2-3), dyslipidemia (25-69% RR: 5) and metabolic syndrome (37-63%, RR: 2-3).…”

Section: Clinical and Lifestyle Causes Of Type 2 Diabetes In Schizophmentioning

confidence: 99%

Schizophrenia and type 2 diabetes mellitus

et al. 2018

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S chizophrenia is associated with increased risk for type 2 diabetes mellitus, resulting in elevated cardiovascular risk and limited life expectancy, translated into a weighted average of 14.5 years of potential life lost and an overall weighted average life expectancy of 64.7 years. The exact prevalence of type 2 diabetes among people with schizophrenia varies across studies and ranges 2-5fold higher than in the general population, whereas the aetiology is complex and multifactorial. Besides common diabetogenic factors, applied similarly in the general population, such as obesity, hyperlipidemia, smoking, hypertension, poor diet and limited physical activity, the co-occurrence of schizophrenia and diabetes is also attributed to unique conditions. Specifically, excessive sedentary lifestyle, social determinants, adverse effects of antipsychotic drugs and limited access to medical care are considered aggravating factors for diabetes onset and low quality of diabetes management. Schizophrenia itself is further proposed as causal factor for diabetes, given the observed higher prevalence of diabetes in young patients, newly diagnosed with schizophrenia and unexposed to antipsychotics. Furthermore, studies support genetic predisposition to diabetes among people with schizophrenia, suggesting shared genetic risk and disclosing a number of overlapped risk loci. Therefore, special attention should be paid in preventing diabetes in people with schizophrenia, through intervention in all possible modifiable risk factors. Implementation of careful antipsychotic prescription, provision of adequate motivation for balanced diet and physical activity and facilitating access to primary health care, could serve in reducing diabetes prevalence. On the other hand, increasing calls are made for early diagnosis of diabetes, application of the appropriate anti-diabetic therapy and strict inspection of therapy adherence, to limit the excess mortality due to cardiovascular events in people with schizophrenia. Moreover, population health programs could help counseling and preventing diabetes risk, additionally to early screening and diagnosis set, aiming to reduce disparities in populations. Finally, mental health-care providers might greatly promote offered health services to patients with schizophrenia, through a holistic individualized approach, considering additionally the physical health of the patients and working closely, preventively and therapeutically, in collaboration with the physicians and diabetologists.

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Section: Clinical and Lifestyle Causes Of Type 2 Diabetes In Schizophmentioning

confidence: 99%

Schizophrenia and type 2 diabetes mellitus

et al. 2018

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“…MDD confers a 60% increased T2D risk (Mezuk, Eaton, Albrecht, & Golden, ), independently from antidepressant therapy (Pan et al, ). SCZ also increases T2D risk, unrelated to antipsychotic therapy, and SCZ patients have higher rates of prediabetes, T2D, MetS, and obesity than control subjects (Q. Li et al, ; Subashini, Deepa, Padmavati, Thara, & Mohan, ) and share common risk variants with MetS traits (Andreassen et al, ). Several studies have demonstrated that drug‐naive SCZ patients have impaired fasting glucose (IFG), impaired insulin action, and increased T2D risk (Dasgupta, Singh, Rout, Saha, & Mandal, ; Fernandez‐Egea et al, ; Ryan, Collins, & Thakore, ; van Nimwegen et al, ); and SCZ/nonaffective psychosis (NAP) are significantly associated with increased odds of parental T2D and first‐degree relatives' impaired‐glucose tolerance (IGT) (Fernandez‐Egea, Miller, Bernardo, Donner, & Kirkpatrick, ; Miller et al, ; Spelman, Walsh, Sharifi, Collins, & Thakore, ).…”

Section: Introductionmentioning

confidence: 99%

Co‐shared genetics and possible risk gene pathway partially explain the comorbidity of schizophrenia, major depressive disorder, type 2 diabetes, and metabolic syndrome

Postolache

Bosque-Plata

Jabbour

et al. 2019

American J of Med Genetics Pt B

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Schizophrenia (SCZ) and major depressive disorder (MDD) in treatment-naive patients are associated with increased risk for type 2 diabetes (T2D) and metabolic syndrome (MetS). SCZ, MDD, T2D, and MetS are often comorbid and their comorbidity increases cardiovascular risk: Some risk genes are likely co-shared by them. For instance, transcription factor 7-like 2 (TCF7L2) and proteasome 26S subunit, non-ATPase 9 (PSMD9) are two genes independently reported as contributing to T2D and SCZ, and PSMD9 to MDD as well. However, there are scarce data on the shared genetic risk among SCZ, MDD, T2D, and/or MetS. Here, we briefly describe T2D, MetS, SCZ, and MDD and their genetic architecture. Next, we report separately about the comorbidity of SCZ and MDD with T2D and MetS, and their respective genetic overlap. We propose a novel hypothesis that genes of the prolactin (PRL)-pathway may be implicated in the comorbidity of these disorders. The inherited predisposition of patients with SCZ and MDD to psychoneuroendocrine dysfunction may confer increased risk of T2D and MetS. We illustrate a strategy to identify risk variants in each disorder and in their comorbid psychoneuroendocrine and mentalmetabolic dysfunctions, advocating for studies of genetically homogeneous and phenotype-rich families. The results will guide future studies of the shared predisposition and molecular genetics of new homogeneous endophenotypes of SCZ, MDD, and metabolic impairment.

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“…21 te Li i sur. 24 u kineskoj populaciji, u kojima nije pronađena povezanost pojave ovisnosti o pušenju s koncentracijama lipida u serumu muškaraca 21 , odnosno, s vrijednostima BMI-ja, među ispitanicima oba spola 24 . U skladu s time, moguće je da neki drugi okolišni čimbenici u puno većoj mjeri pridonose parametrima koji determiniraju metabolički sindrom u shizofreniji, negoli ovisnost o pušenju.…”

Section: Rezultatiunclassified

“…S obzirom na to da ovisnost o pušenju predstavlja čimbenik rizika za metabolički sindrom na koji je moguće utjecati, istraživanje učinka pušenja na metabolički sindrom od posebnog je značaja kako bi se razvile odgovarajuće preventivne mjere u pacijenata. Ipak, zanimljivo je da su dosad svega dvije studije istražile utječe li pojava ovisnosti o pušenju na komponente metaboličkog sindroma u pacijenata sa shizofrenijom 21,24 . Pri tome je, u studiji koju su proveli An i sur.…”

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“…Negativni rezultati proizlaze iz još jedne kineske studije u koju su uključeni kronični paci-jenti oba spola, a istražila je moguću povezanost pušenja s indeksom tjelesne mase (engl. body mass index -BMI), kao pokazateljem prekomjerne tjelesne mase i pretilosti 24 . U skladu s vrlo malo literaturnih podataka o učinku pušenja na metabolički sindrom, odnosno njegove pojedinačne parametre u shizofreniji, u radu smo ispitali pridonosi li, i u kojoj mjeri, pojava ovisnosti o pušenju koncentracijama lipida i glukoze u plazmi i vrijednostima BMI-ja u skupini hrvatskih pacijenata sa shizofrenijom.…”

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Could smoking increase the risk for metabolic syndrome among patients with schizophrenia in a Croatian population?

et al. 2018

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Sažetak. Cilj: Shizofreniju karakterizira visoka učestalost ovisnosti o pušenju, kao i visoka učestalost metaboličkog sindroma. Unatoč tome, malo se zna o učinku pušenja na komponente metaboličkog sindroma u toj bolesti. Cilj ovog rada bio je ispitati pridonosi li, i u kojoj mjeri, pojava ovisnosti o pušenju, koncentracijama lipida i glukoze u plazmi te vrijednostima indeksa tjelesne mase (BMI) u skupini hrvatskih pacijenata sa shizofrenijom. Ispitanici i metode: U istraživanju su sudjelovala 263 kronična pacijenta (muškarci/žene: 139/124) s dijagnozom shizofrenije utvrđenom prema DSM-IV klasifikaciji (engl. Diagnostic and statistical manual for mental disorders -DSM-IV). U pušače su klasificirani ispitanici koji puše najmanje jednu cigaretu dnevno u periodu duljem od godine dana, a u nepušače oni koji su popušili manje od 100 cigareta tijekom života. Rezultati: Unatoč visokoj stopi ovisnosti o pušenju (muškarci: 70,5 %; žene: 60,5 %) nije pronađena značajna razlika u koncentracijama lipida i glukoze u plazmi te vrijednostima BMI-ja između muškaraca pušača i nepušača, a u žena su se samo koncentracije triglicerida razlikovale ovisno o pušačkom statusu. Pri tome su pacijentice koje puše imale nešto više vrijednosti triglicerida u usporedbi s pacijenticama nepušačima (1,6 ± 0,7 vs. 1,3 ± 0,5; F = 4,25, P = 0,042). Ipak, multipla regresijska analiza pokazala je da je samo dob značajni prediktor vrijednosti triglicerida u pacijentica (β = 0,41; promjena R 2 = 0,171; P < 0,001), dok je učinak pušenja na koncentracije triglicerida, kao i na ostale ispitane metaboličke parametre, u pacijenata i pacijentica, ostao izvan granica statističke značajnosti (P > 0,05). Zaključak: Na temelju naših rezultata možemo zaključiti da pušenje ne utječe na koncentracije lipida i glukoze u plazmi te vrijednosti BMI-ja niti u pacijenata niti u pacijentica sa shizofrenijom.Ključne riječi: glukoza u plazmi; indeks tjelesne mase; lipidi u plazmi; pušenje; shizofrenija Abstract. Aim: Schizophrenia is associated with a high rate of nicotine dependence as well as with a high prevalence of metabolic syndrome. However, little is known about the influence of smoking on the metabolic syndrome in this illness. In the current study we aim to investigate whether, and to what extent, smoking may contribute to plasma lipid and glucose concentrations and body mass index (BMI) values in Croatian patients with schizophrenia. Patients and methods: Our study comprised 263 chronically ill patients (males/females: 139/124) who met the criteria for schizophrenia, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Smokers were defined as individuals who smoked more than one cigarette each day for more than one year, and nonsmokers were defined as those who had smoked fewer than 100 cigarettes during their lifetime. Results: Although an elevated smoking rate was detected (males: 70.5%; females: 60.5%), we did not observe significant differences in plasma lipid and glucose concentrations and BMI values between male smokers and nonsmo...

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The prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia

Cited by 42 publications

References 39 publications

Schizophrenia and type 2 diabetes mellitus

Schizophrenia and type 2 diabetes mellitus

Co‐shared genetics and possible risk gene pathway partially explain the comorbidity of schizophrenia, major depressive disorder, type 2 diabetes, and metabolic syndrome

Could smoking increase the risk for metabolic syndrome among patients with schizophrenia in a Croatian population?

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