Saloojee Shamima, Burns Jonathan K, Motala Ayesha A
Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Early Interv Psychiatry. 2018 Dec;12(6):1137-1143. doi: 10.1111/eip.12428. Epub 2017 Apr 12.
To determine the prevalence and incidence of metabolic syndrome in individuals with a first episode of severe mental illness from South Africa.
Antipsychotic naïve study subjects with a first episode of severe mental illness and control subjects were recruited at baseline for a prospective study. Individuals without metabolic syndrome at baseline were followed up for 12 months after antipsychotic medication was initiated. Metabolic syndrome was determined at baseline and at the 12-month follow-up using the Joint Interim Statement criteria.
At baseline, the 67 study (M:F; 48:19) and 67 control subjects (M:F; 48:19) had a mean age of 22.8 (±3.7) and 23.3 (±2.6) years (P = .4), respectively. The majority were of black African ethnicity (97%) and 82% were diagnosed with schizophrenia. There was no difference in the prevalence of metabolic syndrome (4.5%) or any of the individual components between the study and control group prior to the initiation of antipsychotics. Of the 64 study subjects without metabolic syndrome at baseline, only 36 (M:F; 25:11) completed the 12-month follow-up (response rate 56.3%) and 2 subjects developed metabolic syndrome .The incidence of metabolic syndrome was 5.5% with a significant increase in the elevated waist circumference criterion after 1 year of antipsychotic treatment (P = .02).
There was a low prevalence and incidence of metabolic syndrome in this group of patients with a first episode of severe mental illness.
确定南非首次发作严重精神疾病患者中代谢综合征的患病率和发病率。
招募首次发作严重精神疾病且未使用过抗精神病药物的研究对象以及对照对象作为基线进行前瞻性研究。对基线时无代谢综合征的个体在开始使用抗精神病药物后随访12个月。使用联合临时声明标准在基线和12个月随访时确定代谢综合征。
在基线时，67名研究对象（男：女；48：19）和67名对照对象（男：女；48：19）的平均年龄分别为22.8（±3.7）岁和23.3（±2.6）岁（P = 0.4）。大多数为非洲黑人种族（97%），82%被诊断为精神分裂症。在开始使用抗精神病药物之前，研究组和对照组之间代谢综合征的患病率（4.5%）或任何个体组分均无差异。在基线时无代谢综合征的64名研究对象中，只有36名（男：女；25：11）完成了12个月的随访（应答率56.3%），2名研究对象出现了代谢综合征。代谢综合征的发病率为5.5%，在抗精神病药物治疗1年后，腰围升高标准有显著增加（P = 0.02）。
在这组首次发作严重精神疾病的患者中，代谢综合征的患病率和发病率较低。
