A comparison of schizophrenia outpatients treated with antipsychotics with and without metabolic syndrome: findings from the CLAMORS study.
OBJECTIVE
To compare clinical, laboratory, lifestyle, and sociodemographic parameters and cardiac risk in antipsychotic-treated patients with and without metabolic syndrome (MS).


METHODS
A multicenter cross-sectional study in which 117 psychiatrists recruited antipsychotic-treated outpatients meeting DSM-IV criteria for schizophrenia, schizophreniform or schizoaffective disorder. MS was diagnosed when 3 or more of the following criteria were met: waist circumference > 102 cm (men)/> 88 cm (women); serum triglycerides > or = 150 mg/dl; HDL cholesterol < 40 mg/dl (men)/< 50 mg/dl (women); blood pressure > or = 130/85 mmHg; fasting blood glucose > or = 110 mg/dl. The 10-year cardiovascular (CV) risk was assessed by the Systematic COronary Risk Evaluation (SCORE) function (CV mortality) and the Framingham function (any-CV-event).


RESULTS
1452 evaluable patients (863 men, 60.9%), aged 40.7+/-12.2 years and with a mean duration of illness of 15.5+/-10.8 years (mean+/-SD), were included. MS was present in 24.6% [23.6% (men), 27.2% (women); p=0.130]. Overall 10-year risks were 0.9+/-1.9 (SCORE) and 7.2+/-7.6 (Framingham). Coronary heart disease (CHD) 10-year risk was higher in MS patients: 6.6% vs 2.8% showed high/very-high CV mortality risk (SCORE > or = 3%), and 44.2% vs 12.9% high/very-high CV event risk (Framingham > or = 10%) (p<0.001). MS patients also had more psychopathology (PANSS) and greater severity (CGI).


CONCLUSIONS
MS is highly prevalent in antipsychotic-treated patients and is associated with increased cardiovascular risk and psychopathology.
Arango
Celso
C
Psychiatry Department, Hospital General Universitario Gregorio Marañón and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
Bobes
Julio
J
Aranda
Pedro
P
Carmena
Rafael
R
Garcia-Garcia
Margarida
M
Rejas
Javier
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*; D014280:Triglycerides / Q000378:metabolism; D055815:Young Adult
D014150:Antipsychotic Agents; D001786:Blood Glucose; D008078:Cholesterol, LDL; D014280:Triglycerides