title: Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III.
abstract: One important risk factor for cardiovascular disease is the metabolic syndrome (MS), yet limited data exist on its prevalence in US patients with schizophrenia.
  
  
  METHODS
  Using baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial, assessment of MS prevalence was performed based on National Cholesterol Education Program (NCEP) criteria, and also using a fasting glucose threshold of 100 mg/dl (AHA). Subjects with sufficient anthropometric data, data on use of antihypertensives, hypoglycemic medications or insulin, and fasting glucose and lipid values >8 h from last meal were included in the analysis. Comparative analyses were performed using a randomly selected sample from NHANES III matched 1:1 on the basis of age, gender and race/ethnicity.
  
  
  RESULTS
  Of 1460 CATIE baseline subjects, 689 met analysis criteria. MS prevalence was 40.9% and 42.7%, respectively using the NCEP and AHA derived criteria. In females it was 51.6% and 54.2% using the NCEP and AHA criteria, compared to 36.0% (p = .0002) and 36.6% (p = .0003), respectively for males. 73.4% of all females (including nonfasting subjects) met the waist circumference criterion compared to 36.6% of males. In a logistic regression model with age, race and ethnicity as covariates, CATIE males were 138% more likely to have MS than the NHANES matched sample, and CATIE females 251% more likely than their NHANES counterparts. Even when controlling for differences in body mass index, CATIE males were still 85% more likely to have MS than the NHANES male sample, and CATIE females 137% more likely to have MS than females in NHANES.
  
  
  CONCLUSIONS
  The metabolic syndrome is highly prevalent in US schizophrenia patients and represents an enormous source of cardiovascular risk, especially for women. Clinical attention must be given to monitoring for this syndrome, and minimizing metabolic risks associated with antipsychotic treatment.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University, Clinical Research, John Umstead Hospital, 1003 12th Street, Butner, NC 27509, USA. jpmcevoy@duke.edu
authors.forename: Joseph P
authors.initials: JP
authors.lastname: McEvoy
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Meyer
authors.forename: Donald C
authors.initials: DC
authors.lastname: Goff
authors.forename: Henry A
authors.initials: HA
authors.lastname: Nasrallah
authors.forename: Sonia M
authors.initials: SM
authors.lastname: Davis
authors.forename: Lisa
authors.initials: L
authors.lastname: Sullivan
authors.forename: Herbert Y
authors.initials: HY
authors.lastname: Meltzer
authors.forename: John
authors.initials: J
authors.lastname: Hsiao
authors.forename: T
authors.initials: T
authors.lastname: Scott Stroup
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lieberman
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D000959:Antihypertensive Agents / Q000627:therapeutic use; D008076:Cholesterol, HDL / Q000097:blood; D002986:Clinical Trials as Topic; D005215:Fasting; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D007328:Insulin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides