Psychiatry Research Division, Zucker Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004, USA.
Psychiatr Serv. 2010 Sep;61(9):892-8. doi: 10.1176/ps.2010.61.9.892.
A national cardiometabolic screening program for patients in a variety of public mental health facilities, group practices, and community behavioral health clinics was funded by Pfizer Inc. between 2005 and 2008.
A one-day, voluntary metabolic health fair in the United States offered patients attending public mental health clinics free cardiometabolic screening and same-day feedback to physicians from a biometrics testing third party that was compliant with the Health Insurance Portability and Accountability Act.
This analysis included 10,084 patients at 219 sites; 2,739 patients (27%) reported having fasted for over eight hours. Schizophrenia or bipolar disorder was self-reported by 6,233 (62%) study participants. In the overall sample, the mean waist circumference was 41.1 inches for men and 40.4 inches for women; 27% were overweight (body mass index [BMI] 25.0-29.9 kg/m(2)), 52% were obese (BMI >or=30.0 kg/m(2)), 51% had elevated triglycerides (>or=150 mg/dl), and 51% were hypertensive (>or=130/85 mm Hg). In the fasting sample, 52% had metabolic syndrome, 35% had elevated total cholesterol (>or=200 mg/dl), 59% had low levels of high-density lipoprotein cholesterol (<40 mg/dl for men or <50 mg/dl for women), 45% had elevated triglycerides (>or=150 mg/dl), and 33% had elevated fasting glucose (>or=100 mg/dl). Among the 1,359 fasting patients with metabolic syndrome, 60% were not receiving any treatment. Among fasting patients who reported treatment for specific metabolic syndrome components, 33%, 65%, 71%, and 69% continued to have elevated total cholesterol, low levels of high-density lipoprotein, high blood pressure, and elevated glucose levels, respectively.
The prevalence of metabolic syndrome and cardiometabolic risk factors, such as overweight, hypertension, dyslipidemia, and glucose abnormalities, was substantial and frequently untreated in this U.S. national mental health clinic screening program.
辉瑞公司在 2005 年至 2008 年间为各种公共精神卫生机构、集团实践和社区行为健康诊所的患者提供了一项全国性的心脏代谢筛查计划。
在美国,为期一天的自愿代谢健康博览会为参加公共精神卫生诊所的患者提供了免费的心脏代谢筛查,并为符合《健康保险携带和责任法案》的第三方生物统计学测试的医生提供了当天的反馈。
本分析包括 219 个地点的 10084 名患者;2739 名患者(27%)报告说禁食时间超过八小时。6233 名(62%)研究参与者自我报告患有精神分裂症或双相情感障碍。在整个样本中,男性的平均腰围为 41.1 英寸,女性为 40.4 英寸;27%超重(体重指数[BMI]25.0-29.9kg/m²),52%肥胖(BMI≥30.0kg/m²),51%甘油三酯升高(>150mg/dl),51%高血压(>130/85mmHg)。在禁食样本中,52%有代谢综合征,35%总胆固醇升高(>200mg/dl),59%高密度脂蛋白胆固醇水平低(男性<40mg/dl,女性<50mg/dl),45%甘油三酯升高(>150mg/dl),33%空腹血糖升高(>100mg/dl)。在 1359 名有代谢综合征的禁食患者中,60%没有接受任何治疗。在报告有特定代谢综合征成分治疗的禁食患者中,分别有 33%、65%、71%和 69%的患者持续存在总胆固醇升高、高密度脂蛋白水平低、高血压和血糖升高。
在这项美国全国精神卫生诊所筛查计划中,代谢综合征和心脏代谢危险因素(如超重、高血压、血脂异常和葡萄糖异常)的患病率很高,且经常得不到治疗。