GGz Centraal, Amersfoort, the Netherlands; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands.
Phrenos Center of Expertise for Severe Mental Illnesses, Utrecht, the Netherlands.
Compr Psychiatry. 2023 Oct;126:152406. doi: 10.1016/j.comppsych.2023.152406. Epub 2023 Jul 21.
Due to increased cardiometabolic risks and premature mortality in people with severe mental illness (SMI), monitoring cardiometabolic health is considered essential. We aimed to analyse screening rates and prevalences of cardiometabolic risks in routine mental healthcare and its associations with patient and disease characteristics.
We collected screening data in SMI from three mental healthcare institutions in the Netherlands, using most complete data on the five main metabolic syndrome (MetS) criteria (waist circumference, blood pressure, HDL-cholesterol, triglycerides, fasting blood glucose) within a 30-day timeframe in 2019/2020. We determined screened patients' cardiometabolic risks and analysed associations with patient and disease characteristics using multiple logistic regression.
In 5037 patients, screening rates ranged from 28.8% (waist circumference) to 76.4% (fasting blood glucose) within 2019-2020, and 7.6% had a complete measurement of all five MetS criteria. Older patients, men and patients with psychotic disorders had higher odds of being screened. Without regarding medication use, risk prevalences ranged from 29.6% (fasting blood glucose) to 56.8% (blood pressure), and 48.6% had MetS. Gender and age were particularly associated with odds for individual risk factors. Cardiometabolic risk was present regardless of illness severity and did generally not differ substantially between diagnoses, in-/outpatients and institutions.
Despite increased urgency and guideline development for cardiometabolic health in SMI last decades, screening rates are still low, and the MetS prevalence across screened patients is almost twice that of the general population. More intensive implementation strategies are needed to translate policies into action to improve cardiometabolic health in SMI.
由于严重精神疾病（SMI）患者的心血管代谢风险增加和过早死亡，监测心血管代谢健康被认为至关重要。我们旨在分析常规精神卫生保健中的筛查率和心血管代谢风险的流行率，以及其与患者和疾病特征的关系。
我们在 2019/2020 年的 30 天时间内，从荷兰的 3 家精神卫生保健机构收集了 SMI 患者的筛查数据，使用了最多的 5 项主要代谢综合征（MetS）标准（腰围、血压、HDL 胆固醇、甘油三酯、空腹血糖）的完整数据。我们使用多项逻辑回归分析确定了筛查患者的心血管代谢风险，并分析了与患者和疾病特征的关系。
在 5037 名患者中，2019-2020 年期间，筛查率范围从 28.8%（腰围）到 76.4%（空腹血糖），有 7.6%的患者完整测量了所有 5 项 MetS 标准。年龄较大、男性和患有精神病障碍的患者接受筛查的几率更高。不考虑药物使用情况，风险流行率从 29.6%（空腹血糖）到 56.8%（血压）不等，有 48.6%的患者患有 MetS。性别和年龄与个别危险因素的几率特别相关。无论疾病严重程度如何，心血管代谢风险都存在，而且在不同的诊断、门诊和住院患者以及机构之间并没有显著差异。
尽管过去几十年对 SMI 的心血管代谢健康的紧迫性和指南制定有所增加，但筛查率仍然很低，而且筛查患者的 MetS 患病率几乎是一般人群的两倍。需要更强化的实施策略，将政策转化为行动，以改善 SMI 的心血管代谢健康。
