Metabolic syndrome in outpatients receiving antipsychotic therapy in routine clinical practice: A cross-sectional assessment of a primary health care database

Planning Directorate, Badalona Serveis Assistencials SA, Gaietá Soler, 8-entresuelo, 08911 Badalona (Barcelona), Spain.
European Psychiatry (Impact Factor: 3.44). 04/2008; 23(2):100-8. DOI: 10.1016/j.eurpsy.2007.07.005
Source: PubMed


To determine the prevalence of metabolic syndrome (MS) in outpatients treated with antipsychotics included in a primary-health-care database.
A cross-sectional study was carried out assessing an administrative outpatients claim-database from 5 primary-health-centers. Subjects on antipsychotics for more than 3 months were included. The control group was formed by the outpatients included in the database without exposition to any antipsychotic drugs. MS was defined according to the modified NCEP-ATP III criteria, and required confirmation of at least 3 of the 5 following components: body mass index >28.8 kg/m(2), triglycerides >150 mg/ml, HDL-cholesterol <40 mg/ml (men)/<50mg/ml (women), blood pressure >130/85 mmHg, and fasting serum glucose >110 mg/dl.
We identified 742 patients [51.5% women, aged 55.1 (20.7) years] treated with first- or second-generation antipsychotics during 27.6 (20.3) months. Controls were 85.286 outpatients [50.5% women, aged 45.5 (17.7) years]. MS prevalence was significantly higher in subjects on antipsychotics: 27.0% (95% CI, 23.8-30.1%) vs. 14.4% (14.1-14.6%); age- and sex-adjusted OR=1.38 (1.16-1.65, P<0.001). All MS components, except high blood pressure, were significantly more prevalent in the antipsychotic group, particularly body mass index >28.8 kg/m(2): 33.0% (29.6-36.4%) vs. 17.8% (17.6-18.1%), adjusted OR=1.63 (1.39-1.92, P<0.001), and low HDL-cholesterol levels: 48.4% (44.8-52.0%) vs. 29.3% (29.0-29.6%); adjusted OR=1.65 (1.42-1.93, P<0.001). Compared with the reference population, subjects with schizophrenia or bipolar disorder (BD), but not dementia, showed a higher prevalence of MS.
Compared with the general outpatient population, the prevalence of MS was significantly higher in patients with schizophrenia or BD treated with antipsychotics.

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    • "Numerous studies compared prevalence rates between men and women. Most studies revealed substantially increased prevalence rates of MetS in women [Cohn et al. 2004; Kato et al. 2004; McEvoy et al. 2005; Correll et al. 2006; De Hert et al. 2006b; Hagg et al. 2006; Lamberti et al. 2006; Meyer et al. 2006; Bobes et al. 2007; Teixeira and Rochal, 2007; Cerit et al. 2008; Rejas et al. 2008; Sicras-Mainar et al. 2008; Huang et al. 2009; Rezaei et al. 2009; Yazici et al. 2011], up to threefold compared with men [Rezaei et al. 2009]. Fewer studies reported a slight predominance of male sex in MetS rates or no significant differences in rates of MetS across sexes [Heiskanen et al. 2003; Basu et al. 2004; Tirupati and Chua, 2007; Correll et al. 2008; Koponen et al. 2010; Kraemer et al. 2010; Sugawara et al. 2010, 2011]. "
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