title: Clozapine use and sedentary lifestyle as determinants of metabolic syndrome in outpatients with schizophrenia.
abstract: BACKGROUND
  Schizophrenia patients are in danger of developing metabolic syndrome (MetS) and its outcomes type 2 diabetes and cardiovascular disease. Antipsychotic treatment and adverse lifestyle increase the burden of metabolic problems in schizophrenia, but little is known about the role of patients' current psychiatric problems and living arrangements in MetS.
  
  
  OBJECTIVE
  This study aims to evaluate correlations between MetS, severity of psychiatric symptoms, living arrangements, health behaviour and antipsychotic medication in outpatients with schizophrenia spectrum disorders.
  
  
  METHODS
  A general practitioner and psychiatric nurses performed a comprehensive health examination for all consenting patients with schizophrenia spectrum disorders treated in a psychosis outpatient clinic. Examination comprised of an interview, a questionnaire, measurements, laboratory tests and a general clinical examination. Diagnosis of MetS was made according to International Diabetes Federation (IDF) definition. Correlations were calculated and logistic regression analysis performed with SAS.
  
  
  RESULTS
  276 patients (men n = 152, mean age ± standard deviation = 44.9 ± 12.6 years) participated in the study; 58.7% (n = 162) of them had MetS according to the IDF definition. Clozapine use doubled the risk of MetS (OR = 2.04, 95% CI 1.09-3.82, P = 0.03), whereas self-reported regular physical activity decreased the risk significantly (OR = 0.32, 95% CI 0.18-0.57, P < 0.001). We found no correlations between MetS and living arrangements or current severity of psychiatric symptoms.
  
  
  CONCLUSIONS
  MetS was alarmingly common in our sample. Even moderate physical activity was associated with decreased risk of MetS. Promotion of a physically active lifestyle should be one of the targets in treatment of schizophrenia, especially in patients using clozapine.
authors.affiliation: Saana Eskelinen, M.D., Hospital District of Helsinki and Uusimaa, Kellokoski Hospital , Tuusula, FIN-04500 Kellokoski , Finland.
authors.forename: Saana
authors.initials: S
authors.lastname: Eskelinen
authors.forename: Eila
authors.initials: E
authors.lastname: Sailas
authors.forename: Kaisla
authors.initials: K
authors.lastname: Joutsenniemi
authors.forename: Matti
authors.initials: M
authors.lastname: Holi
authors.forename: Jaana
authors.initials: J
authors.lastname: Suvisaari
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009043:Motor Activity; D010045:Outpatients; D012111:Residence Characteristics; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D057185:Sedentary Behavior; D012720:Severity of Illness Index
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine
keywords: Clozapine; Living arrangements; Metabolic syndrome; Physical activity; Schizophrenia