title: The METEOR study:  frequency of metabolic disorders in patients with schizophrenia. Focus on first and second generation and level of risk of antipsychotic drugs.
abstract: The objective of this crosssectional study was to estimate the prevalence of metabolic disorders and hypertension in patients with schizophrenia and to compare prevalence between patients treated with first-generation (FGA) and second-generation (SGA) antipsychotic drugs. The study included 2270 adults with schizophrenia. Patients were assigned to an FGA or SGA stratum on the basis of current treatment. Data were collected on sociodemographic, lifestyle and clinical variables. Blood pressure, waist and hip circumference, blood glucose, triglycerides and cholesterol were measured. The primary evaluation criterion was the prevalence of a glycaemic disorder. Secondary criteria were the prevalence of dyslipidaemia, obesity, hypertension and metabolic syndrome. A propensity score was used to control imbalance between strata. The prevalence of glycaemic disorders was 31.1% (FGA) and 27.6% (SGA). No between-strata difference in prevalence was observed for glycaemic disorders, dyslipidaemia or metabolic syndrome. The prevalence of hypertension was higher (P=0.033) in the FGA group. The proportion of women (but not men) who were overweight or obese was higher in the SGA group (P=0.035), as was the proportion reporting weight gain of more than 5 kg (P<0.001). In an exploratory unadjusted post-hoc analysis, significantly higher frequencies of dysglycaemia (28.5 vs. 22.0%; P=0.006), low HDL cholesterol (35.3 vs. 29.7%; P=0.023) and metabolic syndrome (36.7 vs. 30.7%; P=0.021) were observed in patients taking SGAs considered to carry high metabolic risk compared with those taking low-risk agents. In conclusion, metabolic disorders are prevalent in patients with schizophrenia treated with antipsychotics and are under-diagnosed and under-treated.
authors.affiliation: INSERM U669, Université Paris-Sud and Université Paris-Descartes, France. falissard_b@wanadoo.fr
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
authors.forename: Mauro
authors.initials: M
authors.lastname: Mauri
authors.forename: Ken
authors.initials: K
authors.lastname: Shaw
authors.forename: Tilman
authors.initials: T
authors.lastname: Wetterling
authors.forename: Adam
authors.initials: A
authors.lastname: Doble
authors.forename: Agnès
authors.initials: A
authors.lastname: Giudicelli
authors.forename: Marc
authors.initials: M
authors.lastname: De Hert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002784:Cholesterol; D015897:Comorbidity; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D005060:Europe; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D007406:Interview, Psychological; D008297:Male; D008659:Metabolic Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D017891:Pharmacoepidemiology; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology* / Q000378:metabolism; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D015430:Weight Gain; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol