Department of General Psychiatry, Seoul National Hospital, Seoul, Korea.
Clin Psychopharmacol Neurosci. 2013 Aug;11(2):80-8. doi: 10.9758/cpn.2013.11.2.80. Epub 2013 Aug 26.
To examine the prevalence of metabolic syndrome and its risk factors in a large group of schizophrenic patients.
Sociodemographic and treatment data were collected from medical records of 1,103 inpatients and outpatients treated for schizophrenia at Seoul National Hospital in Seoul, Korea. Anthropometric measurement and blood testing were conducted for collection of physical and biochemical data and diagnosis of metabolic syndrome. Data for metabolic syndrome prevalence were compared by sex, age, metabolic syndrome markers present, treatment of markers, and types of antipsychotics and individual drug agents used.
Mean prevalence of metabolic syndrome in all subjects was 43.9% and 40.1% according to adapted Adult Treatment Panel III (ATP-IIIa) and International Diabetes Federation criteria, respectively. No significant differences were found in prevalence according to ATP-IIIa criteria between men (42.6%) and woman (45.9%). A trend toward higher prevalence with age was observed for both sexes until 50 years, followed by a continued increase for women but a decrease for men. Use of a combination of atypical antipsychotics was associated with the highest metabolic syndrome prevalence and use of aripiprazole with the lowest. High percentages of subjects with hypertension and dyslipidemia were not being treated for these conditions.
Despite their higher prevalence in schizophrenic patients, metabolic syndrome and its markers are not being adequately managed in these patients. Treatment of schizophrenic patients requires attention to not only their psychiatric conditions but also associated medical conditions by individual health care practitioners and hospitals as well as the public health care sector as a whole.
调查大量精神分裂症患者中代谢综合征及其危险因素的流行情况。
收集韩国首尔国立医院收治的 1103 名精神分裂症住院和门诊患者的社会人口学和治疗数据。进行人体测量和血液检测以收集身体和生化数据并诊断代谢综合征。根据性别、年龄、存在的代谢综合征标志物、标志物治疗、抗精神病药物类型和使用的个别药物制剂比较代谢综合征患病率数据。
根据适应的成人治疗小组 III(ATP-IIIa)和国际糖尿病联合会标准,所有受试者代谢综合征的平均患病率分别为 43.9%和 40.1%。根据 ATP-IIIa 标准,男性(42.6%)和女性(45.9%)之间的患病率无显著差异。男女两性的患病率均随着年龄的增长呈上升趋势,直到 50 岁,随后女性的患病率继续上升,而男性的患病率则下降。联合使用非典型抗精神病药物与代谢综合征患病率最高相关,而使用阿立哌唑与代谢综合征患病率最低相关。患有高血压和血脂异常的患者中,有很大比例的人未对这些病症进行治疗。
尽管精神分裂症患者的代谢综合征及其标志物的患病率更高,但这些患者的代谢综合征及其标志物并未得到充分治疗。治疗精神分裂症患者不仅需要关注他们的精神状况,还需要个体医疗保健从业者、医院以及整个公共医疗保健部门关注他们的相关医疗状况。