Research Division, Institute of Mental Health, Singapore.
Compr Psychiatry. 2017 Apr;74:196-203. doi: 10.1016/j.comppsych.2017.01.017. Epub 2017 Feb 2.
Metabolic syndrome (MetS) and cardiovascular risk are highly prevalent among individuals with schizophrenia. This study aimed to determine the cardiometabolic profile and the associated risk factors in a group of institutionalized patients with schizophrenia or schizoaffective disorder receiving prolonged hospital care in the only tertiary psychiatric institution in Singapore.
Patients residing in long stay wards who were hospitalized for a minimum period of 1year were recruited. Fasting blood sample was collected to obtain levels of blood glucose, total cholesterol, high-density lipoprotein (HDL) and triglycerides. Waist circumference, blood pressure, height and weight were also measured. The prevalence of MetS and the 10-year cardiovascular risk were determined.
This inpatient group had a mean age of 56.1years and an average length of hospitalization of 8.8years. The prevalence of MetS in this group was 51.9% and 26.9% based on the AHA/NHLBI and modified NCEP ATP III criteria respectively. Those in the high risk BMI category and those who had pre-existing diabetes had higher odds of MetS. Their 10-year cardiovascular risk was estimated at 12.8%, indicating intermediate risk based on the Framingham risk function.
Despite the low smoking rate in this group of inpatients, their cardiovascular risk appeared to be relatively high possibly due to old age and age-related conditions such as hypertension and low HDL. While literature has found the use of atypical antipsychotic medications to increase the risk of MetS, we did not find any significant association. Additionally, the duration of hospitalization did not affect the rate of MetS in our sample.
代谢综合征（MetS）和心血管风险在精神分裂症患者中非常普遍。本研究旨在确定新加坡唯一的三级精神病院中接受长期住院治疗的一组精神分裂症或分裂情感障碍患者的心脏代谢特征及其相关危险因素。
招募居住在长期住院病房、住院时间至少 1 年的患者。采集空腹血样以测定血糖、总胆固醇、高密度脂蛋白（HDL）和甘油三酯水平。还测量了腰围、血压、身高和体重。确定了 MetS 的患病率和 10 年心血管风险。
该住院患者组的平均年龄为 56.1 岁，平均住院时间为 8.8 年。根据 AHA/NHLBI 和改良 NCEP ATP III 标准，该组 MetS 的患病率分别为 51.9%和 26.9%。处于高风险 BMI 类别和患有既往糖尿病的患者发生 MetS 的几率更高。根据 Framingham 风险函数，他们的 10 年心血管风险估计为 12.8%，表明风险处于中等水平。
尽管该住院患者组的吸烟率较低，但他们的心血管风险似乎相对较高，可能是由于年龄较大以及高血压和低 HDL 等与年龄相关的疾病。虽然文献发现使用非典型抗精神病药物会增加发生 MetS 的风险，但我们没有发现任何显著的相关性。此外，住院时间的长短并没有影响我们样本中 MetS 的发生率。
