Metabolic syndrome and aerobic fitness in patients with first-episode schizophrenia, including a 1-year follow-up.
OBJECTIVE
To compare the prevalence of metabolic syndrome (MetS) and metabolic abnormalities in patients with first-episode schizophrenia (FES) with sex- and age-matched healthy controls; to investigate changes in MetS during 1year of treatment; and to investigate predictors of MetS.


METHODS
Patients with FES (N=99) and healthy controls (N=50) were included in the study. MetS was defined according to IDF based on waist circumference (WC), blood pressure (BP), triglycerides (TG), high-density lipoprotein (HDL), and fasting-glucose. Data on physical activity, aerobic fitness, smoking, and dietary habits, sleeping disturbances, psychopathology and psychotropic medication were also obtained. Patients were assessed at baseline and at 1year follow-up.


RESULTS
Compared with healthy controls patients with FES had a higher baseline prevalence of MetS (p=.07), and metabolic abnormalities: WC (p<.01), TG (p<.01), HDL (p=.017), and fasting glucose (p=.04). Patients with FES had significantly increased prevalence of MetS (p=.03), WC (p=.04), and TG (p=.01) during the study period. Antipsychotics and low physical activity were significantly correlated with the increase in metabolic abnormalities. In multivariate analyses low aerobic fitness was the most consistent and significant predictor of metabolic abnormalities and MetS.


CONCLUSIONS
MetS and metabolic abnormalities are highly prevalent in patients with FES, and both increase significantly during 1year of treatment. Apart from confirming the metabolic adverse effects of antipsychotics, our study highlights that low aerobic fitness is a significant risk factor for MetS. Promoting a healthier lifestyle should be part of psychiatric treatment and rehabilitation.
The Research Unit, Department of Affective Disorders Q, Aarhus University Hospital, Risskov, Denmark. Electronic address: lene.nyboe@ps.rm.dk.
L
L
Nyboe
The Research Unit, Department of Affective Disorders Q, Aarhus University Hospital, Risskov, Denmark.
C H
CH
Vestergaard
Horsens Regional Hospital, Department of Medicine, Denmark. Electronic address: marianne.kleis@horsens.rm.dk.
M K
MK
Moeller
SEARCH - Research Group for Synthesis of Evidence and Research, Research Unit for Musculoskeletal Function and Physiotherapy (FoF), Department of Sports Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Center for Evidence-based Practice, Bergen University College, Bergen, Norway. Electronic address: h-lund@health.sdu.dk.
H
H
Lund
The Research Unit, Department of Affective Disorders Q, Aarhus University Hospital, Risskov, Denmark.
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P
Videbech
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001794:Blood Pressure; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology*; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy / Q000534:rehabilitation*; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism; D055105:Waist Circumference; D055815:Young Adult
D014150:Antipsychotic Agents; D014280:Triglycerides
Aerobic fitness; First-episode schizophrenia; Lifestyle habits; Metabolic syndrome; Physical activity