title: Changes in metabolic parameters in patients with severe mental illness over a 10-year period: A retrospective cohort study.
abstract: BACKGROUND
  Diabetes, obesity and metabolic syndrome are highly prevalent in patients with severe mental illness and can impose a major physical health burden.
  
  
  OBJECTIVE
  To determine how anthropometric and metabolic features changed over time in a retrospective cohort of people with Severe Mental Illness living in Cheshire, UK.
  
  
  METHODS
  In all, 1307 individuals on the severe mental illness Register were followed up between 2002 and 2012 in UK general practice. Subjects were identified through a pseudanonymised search of general practice registers.
  
  
  RESULTS
  Baseline body mass index was 28.6 kg/m2increasing to 31.0 at 10-year follow-up ( r2= 0.84; p = 0.0002). There was a significant increase in fasting blood glucose from 5.72 to 6.79 mmol/L ( r2= 0.48; p = 0.026). Correspondingly, there was a strong positive univariate relation between increase in body mass index and fasting blood glucose ( r2= 0.54; p < 0.0001) taking into account all measurements. Fasting blood glucose also increased slightly with age ( p = 0.028). With increasing use of statins, total cholesterol fell from 4.5 to 3.9 mmol/L ( r2= 0.88; p = 0.0001), as did low-density lipoprotein cholesterol from 3.43 to 2.35 mmol/L ( r2= 0.94; p = 0.0001). In multivariate models, adjusting for age, gender, smoking and blood pressure, each unit increase in body mass index (odds ratio = 1.07 [1.01, 1.13]; p = 0.031) and triglycerides (odds ratio = 1.28 (1.06, 1.55); p = 0.009) was independently associated with an increased risk of having type 2 diabetes.
  
  
  CONCLUSIONS
  Increasing body mass index relates to increasing rates of dysglycaemia over time. Measures to encourage weight reduction should be key strategies to reduce dysglycaemia rates in severe mental illness. Prescribing statins may have been effective in improving the lipid profile in this group.
authors.affiliation: 1 The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.|2 Department of Medicine, Leighton Hospital, Crewe, UK.
authors.forename: Adrian H
authors.initials: AH
authors.lastname: Heald
authors.affiliation: 3 Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Martin
authors.affiliation: 4 Centre for Integrated Genomic Medical Research, University of Manchester, Manchester, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Payton
authors.affiliation: 1 The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
authors.forename: Luma
authors.initials: L
authors.lastname: Khalid
authors.affiliation: 5 Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK.|6 The George Institute for Global Health, Oxford Martin School, University of Oxford, Oxford, UK.
authors.forename: Simon G
authors.initials: SG
authors.lastname: Anderson
authors.affiliation: 1 The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
authors.forename: R Prakash
authors.initials: RP
authors.lastname: Narayanan
authors.affiliation: 7 Department of Neurosciences, University Psychiatric Centre, Katholieke Universiteit Leuven, Kortenberg, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Hert
authors.affiliation: 8 Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Yung
authors.affiliation: 9 Department of Blood Sciences, Walsall Manor Hospital, Walsall, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Livingston
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000378:metabolism*; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose
keywords: Severe enduring mental illness; body mass index; diabetes; glucose; primary care