Department of Psychiatry, Hacettepe University, Ankara, Turkey.
Eur Arch Psychiatry Clin Neurosci. 2011 Feb;261(1):69-78. doi: 10.1007/s00406-010-0118-x. Epub 2010 Jun 3.
Most studies point to an increased prevalence of metabolic syndrome (MS) and an increased risk of coronary heart disease (CHD) in schizophrenia patients with MS. The aims of this study were to compare the prevalence of MS in schizophrenia patients with the general population, to explore the clinical correlates and predictors of MS and to evaluate the risk for CHD within 10 years. Consecutive 319 patients, aged 18-75 years, with a diagnosis of schizophrenia according to the DSM-IV were enrolled. The ATP-III, the ATP-IIIA and the IDF criteria were used to define MS. 10-year risk of CHD events was calculated with the Framingham score. One hundred nine (34.2%) patients met the ATP-III criteria, 118 (37%) the ATP-IIIA and 133 (41.7%) the IDF criteria for MS. Patients with MS were older, had a later onset of illness and an older age at first hospitalization. The prevalence of MS in schizophrenia patients was higher from the general population only within the 20-29 age group. Patients with MS had a higher age and sex-corrected 10-year risk of CHD events. The only predictor of MS was the age of illness onset. In conclusion, countries where the general population prevalence of MS is already too high, schizophrenia patients younger than 30 years of age might be under higher risk of morbidity and mortality related with MS. This study points to the necessity for aggressive interventions to correct MS in schizophrenia as early as possible, within the first 10 years of post detection.
大多数研究表明,代谢综合征(MS)在精神分裂症患者中更为普遍,且此类患者罹患冠心病(CHD)的风险增加。本研究旨在比较精神分裂症患者与一般人群中 MS 的患病率,探讨 MS 的临床相关因素和预测因素,并评估 10 年内 CHD 的发病风险。连续纳入了 319 名年龄在 18-75 岁之间,符合 DSM-IV 精神分裂症诊断标准的患者。采用 ATP-III、ATP-IIIA 和 IDF 标准来定义 MS。用 Framingham 评分计算 10 年内 CHD 事件的风险。109 名(34.2%)患者符合 ATP-III 标准,118 名(37%)符合 ATP-IIIA 标准,133 名(41.7%)符合 IDF 标准。MS 患者年龄较大,发病年龄较晚,首次住院年龄较大。仅在 20-29 岁年龄组,MS 在精神分裂症患者中的患病率高于一般人群。MS 患者的 CHD 发病风险校正后,年龄较大,且男性的 10 年 CHD 发病风险较高。MS 的唯一预测因素是发病年龄。综上所述,在一般人群中 MS 患病率已经过高的国家,年龄在 30 岁以下的精神分裂症患者可能面临更高的与 MS 相关的发病率和死亡率风险。本研究表明,需要积极干预,尽早(在检出后 10 年内)纠正精神分裂症患者的 MS。