Cost-effective screening for the metabolic syndrome in patients treated with second-generation antipsychotic medications.
OBJECTIVE
Despite concerns about the adverse effects of second-generation antipsychotics on weight regulation and glucose and lipid metabolism, little is known about the relationship between these agents and the metabolic syndrome. Because the metabolic syndrome is more strongly associated with cardiovascular morbidity and mortality than its individual components, attention to the full syndrome is important. The authors' goal was to explore the relationship between second-generation antipsychotics and the metabolic syndrome.


METHODS
They assessed the prevalence of metabolic syndrome in a nearly consecutive group of 89 acutely admitted psychiatric inpatients treated with at least one second-generation antipsychotic for different psychiatric disorders. Patients' waist circumference and blood pressure were measured as well as their fasting blood glucose and lipid levels.


RESULTS
Twenty-six (29.2%) of the 89 patients fulfilled criteria for the metabolic syndrome. Presence of the syndrome was associated with older age, higher body mass index, and higher values for each individual criterion of the metabolic syndrome but not with specific diagnoses or antipsychotic treatment regimens. Presence of abdominal obesity was most sensitive (92.0%), while fasting glucose >110 mg/dl was most specific (95.2%) in correctly identifying the presence of metabolic syndrome. Combining abdominal obesity and elevated fasting blood glucose had 100% sensitivity.


CONCLUSIONS
The measurement of both abdominal obesity and fasting blood glucose is a simple, cost-effective screening test to detect patients at high risk for future cardiovascular morbidity.
Straker
David
D
Department of Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA. nyrpsychdoc@aol.com
Correll
Christoph U
CU
Kramer-Ginsberg
Elisse
E
Abdulhamid
Nasreen
N
Koshy
Fiju
F
Rubens
Elayna
E
Saint-Vil
Robert
R
Kane
John M
JM
Manu
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D003362:Cost-Benefit Analysis; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000175:diagnosis; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D001523:Mental Disorders / Q000188:drug therapy*; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis*; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced / Q000175:diagnosis; D015995:Prevalence
D014150:Antipsychotic Agents; D001786:Blood Glucose