title: The prevalence and clinical-demographic correlates of diabetes mellitus in chronic schizophrenic patients receiving clozapine.
abstract: OBJECTIVE
  To examine the prevalence and correlates of diabetes in a large sample of Chinese patients with schizophrenia on long-term clozapine treatment, because this population previously has received little systematic study.
  
  
  METHODS
  Two hundred and six inpatients meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition schizophrenia criteria were recruited in a cross-sectional naturalistic study, and compared with 615 healthy control subjects matched for age, sex, education, and body mass index (BMI). The patient's psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Diagnoses of diabetes were established through review of medical records and fasting blood glucose testing, or an oral glucose tolerance test.
  
  
  RESULTS
  Diabetes mellitus was more common in patients than in the normal controls (22.3% vs 6.2%) (odds ratio = 4.37, confidence interval (CI) 2.76-6.92, p < 0.001). The prevalence of diabetes increased with age across five age-groups as compared with normal controls (X(2) = 18.0, df = 4, p = 0.001). The PANSS total score and sub-scores showed no differences between the diabetic and non-diabetic groups. Logistic regression in the patients revealed significant associations between diabetes and a family history of diabetes (p < 0.001), age (p < 0.01), and BMI (p < 0.05).
  
  
  CONCLUSIONS
  Long-term clozapine treatment was associated with an increased and clinically important risk of diabetes mellitus in Chinese chronic schizophrenic patients, which is consistent with previous reports in Western populations.
authors.affiliation: 2nd Hospital affiliated to Xinxiang Medical University, Xinxiang City, Henan Province, China.
authors.forename: Ruiling
authors.initials: R
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Hao
authors.forename: Miao
authors.initials: M
authors.lastname: Pan
authors.forename: Chuansheng
authors.initials: C
authors.lastname: Wang
authors.forename: Xiuli
authors.initials: X
authors.lastname: Zhang
authors.forename: Da Chun
authors.initials: DC
authors.lastname: Chen
authors.forename: Mei Hong
authors.initials: MH
authors.lastname: Xiu
authors.forename: Fu De
authors.initials: FD
authors.lastname: Yang
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kosten
authors.forename: Xiang Yang
authors.initials: XY
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D003024:Clozapine