Metabolic syndrome: differences between psychiatric and internal medicine patients.
OBJECTIVE
The existence of specific features of Metabolic Syndrome (MetS) in psychiatric population in comparison to not psychiatric patients has not been systematically investigated. The purpose of this study is to evaluate the differences of MetS among a group of psychiatric patients and a group of internal medicine patients in terms of anthropometric measurements, biochemical variables, and cardiovascular risk.


METHODS
We enrolled 83 psychiatric inpatients under pharmacological treatment (schizophrenia n = 24, bipolar disorder n = 27, major depression n = 14, other n = 18) and 77 internal medicine patients visited for supposed MetS as affected by overweight or arterial hypertension.


RESULTS
Psychiatric patients differed from control subjects by age (yrs) (47 +/- 9 vs. 52 +/- 8.6, p = 0.001), waist circumference (cm) (111.9 +/- 10.9 vs. 106 +/- 12.6, p = 0.02), HDL cholesterol (mg/dl) (36.8 +/- 7 vs. 48 +/- 11.3, p = 0.001), serum insulin (microU/ml) (26 +/- 12.5 vs. 16.4 +/- 8.8, p = 0.001), triglyceride/HDL cholesterol ratio (4.8 +/- 2.7 vs. 3.3 +/- 2.2, p = 0.01). Female psychiatric patients had higher levels of triglycerides (mg) (178 + 86 vs. 115 + 53, p = 0.002) and of HOMA index (7.8 + 5 vs. 3.8 + 3.3, p = 0.005). Triglycerides and triglycerides/HDL ratio levels were higher in Unipolar Depression. A positive association was found between antidepressant drug treatment with triglycerides and triglycerides/HDL ratio levels, neuroleptic treatment with the HOMA index, and antipsychotics drugs with the Framingham index.


CONCLUSIONS
Psychiatric study population numerosity and duration of psychiatric illness and drug treatment.


CONCLUSIONS
Specific features of MetS in psychiatric population are mainly represented by young age of onset, hyperinsulinemia, increased abdominal adiposity, and low HDL cholesterol whose common denominator may be insulin-resistance.
University "Aldo Moro" of Bari, Italy. francesco.margari@uniba.it
Francesco
F
Margari
Madia
M
Lozupone
Rossella
R
Pisani
Adriana
A
Pastore
Orlando
O
Todarello
Giuseppina
G
Zagaria
Francesco
F
Minerva
Giuseppe
G
Palasciano
Vincenzo
V
Palmieri
D050154:Adiposity / Q000502:physiology; D000328:Adult; D017668:Age of Onset; D000928:Antidepressive Agents / Q000494:pharmacology; D014150:Antipsychotic Agents / Q000494:pharmacology; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology*; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology / Q000503:physiopathology*; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D008076:Cholesterol, HDL; C034396:HDL-triglyceride; D007328:Insulin; D008075:Lipoproteins, HDL; D014280:Triglycerides