Bobes Julio, Arango Celso, Aranda Pedro, Carmena Rafael, Garcia-Garcia Margarida, Rejas Javier
Medicine Department, Psychiatry Area, University of Oviedo, Asturias, Spain.
Schizophr Res. 2007 Feb;90(1-3):162-73. doi: 10.1016/j.schres.2006.09.025. Epub 2006 Nov 21.
To assess the prevalence of Coronary Heart Disease (CHD) and Metabolic Syndrome (MS) in patients treated with antipsychotics.
Retrospective, cross-sectional, multicenter study in which 117 Spanish psychiatrists (the CLAMORS Study Collaborative Group) recruited consecutive outpatients meeting DSM-IV criteria for Schizophrenia, Schizophreniform or Schizoaffective Disorder, receiving antipsychotic treatment for at least 12 weeks. CHD risk was assessed by SCORE (10-year CV death) and Framingham (10-year all CHD events) function. MS was defined by at least 3 of the following components: waist circumference >102 (men)/>88 (women) cm; triglycerides > or =150 mg/dl; HDL-cholesterol <40 mg/dl (men)/<50 mg/dl (women); blood pressure > or =130/85; fasting glucose > or =110 mg/dl.
1452 evaluable patients (863 men, 60.9%), aged 40.7+/-12.2 years (mean+/-SD) were included. MS was present in 24.6% [23.6% (men), 27.2% (women); p=0.130)]. The overall 10-year risks were 0.9+/-1.9 (SCORE) and 7.2+/-7.6 (Framingham). 8% (95%CI: 6.5-9.5) and 22.1% (95%CI: 20.0-24.3) of patients showed a high/very high risk according to SCORE (> or =3%) and Framingham (> or =10%) function. Abdominal obesity and low HDL-cholesterol were more prevalent in women: 54.5% (95%CI: 50.2-58.9) versus 34.3% (95%CI: 31.0-37.7), and 46.1% (95%CI: 41.4) versus 28.5 (95%CI: 50.8), p<0.001 in both cases. Hypertension and hypertriglyceridemia were more prevalent in men: 59.0% (95%CI: 55.7-62.3) versus 46.0% (95%CI: 41.8-50.2), and 40.7% (95%CI: 37.2-44.2) versus 32.4 (95%CI: 28.3-36.5), p<0.01 in both cases.
CHD risk and MS prevalences among patients with schizophrenia treated with antipsychotics were in the same range as the Spanish general population 10 to 15 years older.
评估接受抗精神病药物治疗的患者中冠心病（CHD）和代谢综合征（MS）的患病率。
一项回顾性、横断面、多中心研究，117名西班牙精神科医生（CLAMORS研究协作组）招募了符合精神分裂症、分裂样精神障碍或分裂情感性障碍DSM-IV标准的连续门诊患者，这些患者接受抗精神病药物治疗至少12周。通过SCORE（10年心血管死亡风险）和弗雷明汉（10年所有冠心病事件风险）函数评估冠心病风险。MS由以下至少3个成分定义：腰围>102（男性）/>88（女性）厘米；甘油三酯>或=150毫克/分升；高密度脂蛋白胆固醇<40毫克/分升（男性）/<50毫克/分升（女性）；血压>或=130/85；空腹血糖>或=110毫克/分升。
纳入了1452例可评估患者（863名男性，占比60.9%），年龄为40.7±12.2岁（均值±标准差）。MS的患病率为24.6%[23.6%（男性），27.2%（女性）；p = 0.130]。总体10年风险分别为0.9±1.9（SCORE）和7.2±7.6（弗雷明汉）。根据SCORE（>或=3%）和弗雷明汉（>或=10%）函数，分别有8%（95%置信区间：6.5 - 9.5）和22.1%（95%置信区间：20.0 - 24.3）的患者显示为高/极高风险。腹部肥胖和低高密度脂蛋白胆固醇在女性中更为普遍：分别为54.5%（95%置信区间：50.2 - 58.9）和34.3%（95%置信区间：31.0 - 37.7），以及46.1%（95%置信区间：41.4）和28.5（95%置信区间：50.8），两种情况p均<0.001。高血压和高甘油三酯血症在男性中更为普遍：分别为59.0%（95%置信区间：55.7 - 62.3）和46.0%（95%置信区间：41.8 - 50.2），以及40.7%（95%置信区间：37.2 - 44.2）和32.4（95%置信区间：28.3 - 36.5），两种情况p均<0.01。
接受抗精神病药物治疗的精神分裂症患者中冠心病风险和MS患病率与年龄大10至15岁的西班牙普通人群处于同一范围。
