Getenet Helena, Feleke Yeweyenhareg, Tsigebrhan Ruth, Lejisa Tadesse, Ashebir Genet
Department of Internal Medicine, Endocrinology and Metabolism Unit, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Psychiatryand, School of Medicine , WHO Collaborating Center in Mental Health Research and Capacity-Building, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Psychiatry. 2025 Apr 14;25(1):370. doi: 10.1186/s12888-025-06845-w.
Metabolic syndrome (MetS) is the leading cause of mortality and morbidity in patients with severe mental illness (SMI). The present study was designed to determine the prevalence and associated factors of MetS among people with SMI attending the Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia.
A hospital-based cross-sectional study was conducted among people with SMI attending the outpatient psychiatric department. Socio-demographic and other clinical data were collected using a structured questionnaire. A standardized chemistry analyzer measured lipid profiles and blood glucose levels at the Ethiopian Public Health Institute. Univariable and multivariable logistic regression analysis was conducted to examine the association of the outcome with clinical and socio-demographic variables.
A total of 305 participants with SMI were recruited, 79% (n = 241) were male. The overall prevalence of MetS was 28.5% (n = 87), 31.5% (n = 63) among all the participants diagnosed with schizophrenia, and 25% (n = 13) among participants diagnosed with bipolar disorders. The most frequent metabolic abnormality was low high-density lipoprotein (HDL) 88.5% (n = 77). About 54% (n = 47) had abnormal waist circumference; 27.5% (n = 84) of the participants had a blood pressure of ≥ 130/85 mmHg; 4.6% (n = 14) had fasting blood glucose above 100 mg/dl; and 36.4% (n = 111) had triglyceride levels above 150 mg/dl. On multivariable analysis, increasing age (Adjusted odds ratio (aOR) = 1.12, 95% CI 1.08, 1.16) and having secondary education and above (aOR = 2.64, 95% CI 1.24, 5.50) compared to primary education, increasing duration of treatment (aOR = 1.11, 95% CI 1.03, 1.18) and alcohol use (aOR = 1.89, 95% CI 1.03, 3.47) were associated with MetS. 27.2% (n = 83) of the participants with SMI were overweight, and 4.6% (n = 14) had obesity. Increasing age (aOR = 1.11, 95% CI 1.05, 1.14), being female (aOR = 2.42, 95% CI 1.17, 5.01), smoking (aOR = 2.83, 95% CI 1.30, 6.15) and use of second-generation antipsychotics (aOR = 2.64, 95% CI 1.41, 4.94) were significantly associated with being overweight/obesity.
Individuals with SMI receiving care at a tertiary healthcare facility in Ethiopia exhibited a high prevalence of overweight/obesity and MetS. Therefore, health education and early screening for the components of MetS in this vulnerable population are recommended.
代谢综合征（MetS）是严重精神疾病（SMI）患者发病和死亡的主要原因。本研究旨在确定在埃塞俄比亚亚的斯亚贝巴阿马努埃尔精神专科医院就诊的SMI患者中MetS的患病率及相关因素。
在门诊精神科就诊的SMI患者中开展了一项基于医院的横断面研究。使用结构化问卷收集社会人口学和其他临床数据。在埃塞俄比亚公共卫生研究所，用标准化化学分析仪测量血脂谱和血糖水平。进行单变量和多变量逻辑回归分析，以检验结果与临床及社会人口学变量之间的关联。
共招募了305名SMI患者，79%（n = 241）为男性。MetS的总体患病率为28.5%（n = 87），在所有诊断为精神分裂症的参与者中为31.5%（n = 63），在诊断为双相情感障碍的参与者中为25%（n = 13）。最常见的代谢异常是高密度脂蛋白（HDL）低，占88.5%（n = 77）。约54%（n = 47）的人腰围异常；27.5%（n = 84）的参与者血压≥130/85 mmHg；4.6%（n = 14）的人空腹血糖高于100 mg/dl；36.4%（n = 111）的人甘油三酯水平高于150 mg/dl。多变量分析显示，与小学教育相比，年龄增加（调整优势比[aOR]=1.12，95%置信区间[CI] 1.08，1.16）、接受过中等及以上教育（aOR = 2.64，95% CI 1.24，5.50）、治疗时间延长（aOR = 1.11，95% CI 1.03，1.18）和饮酒（aOR = 1.89，95% CI 1.03，3.47）与MetS相关。27.2%（n = 83）的SMI患者超重，4.6%（n = 14）患有肥胖症。年龄增加（aOR = 1.11，95% CI 1.05，1.14）、女性（aOR = 2.42，95% CI 1.17，5.01）、吸烟（aOR = 2.83，95% CI 1.30，6.15）和使用第二代抗精神病药物（aOR = 2.64，95% CI 1.41，4.94）与超重/肥胖显著相关。
在埃塞俄比亚一家三级医疗机构接受治疗的SMI患者中，超重/肥胖和MetS的患病率很高。因此，建议对这一弱势群体进行健康教育并尽早筛查MetS的各项指标。
