title: Physiological characteristics of patients with schizophrenia prematurely dying from circulatory diseases.
abstract: BACKGROUND
  Patients with schizophrenia before reaching geriatric age are at high risk of circulatory mortality. However, investigations are lacking on the characteristics of physiological measurement among these at-risk patients.
  
  
  METHODS
  In this study, we followed acutely inpatients with schizophrenia disorder for cause of death through record linkage to the Death Certification System in Taiwan. Cases of patients who died because of circulatory morbidity (ICD-9 401-443) before turning 65 years old were used. Each schizophrenia case was then matched with two mentally healthy controls for the age and sex, and date of laboratory examination. Clinical data of all subjects were obtained by reviewing medical records.
  
  
  RESULTS
  Totally, 81 patients with schizophrenia who died from circulatory diseases at mean ages of 48.0 ± 10.7 years were investigated. The mean age at the final acute psychiatric hospitalization was 43.0 ± 10.9 years. Multivariate analysis showed that elevated fasting serum glucose levels (95% confidence interval [CI] for odds ratio (OR) = 1.00-1.03), blood leukocyte counts (95% CI for odds ratio (OR) = 1.07-1.55), and heart rates on electrocardiogram (95% CI for OR = 1.04-1.10) in the final psychiatric hospitalization collectively provided the predictive validity for premature circulatory death.
  
  
  CONCLUSIONS
  Systemic inflammatory activation and autonomic nervous system dysfunction along with dysregulation of glucose metabolism rather than lipids could be the physiological characteristics of schizophrenia patients at risk of premature circulatory mortality.
authors: Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Pao-Huan
authors: PH
authors: Chen
authors: Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.|Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors: Shang-Ying
authors: SY
authors: Tsai
authors: Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.|Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
authors: Chian-Jue
authors: CJ
authors: Kuo
authors: Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.|Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors: Kuo-Hsuan
authors: KH
authors: Chung
authors: Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Shou-Hung
authors: SH
authors: Huang
authors: Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.|Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
authors: Chiao-Chicy
authors: CC
authors: Chen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000401:mortality*; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D014652:Vascular Diseases / Q000401:mortality
chemical_list: D001786:Blood Glucose
keywords: autonomic nervous system dysfunction; circulatory mortality; hyperglycemia; schizophrenia; systemic inflammation