Prevalence of Metabolic Syndrome in Patients with Schizophrenia in Korea: A Multicenter Nationwide Cross-Sectional Study

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Abstract

Objective

We designed a nationwide study with limited exclusion criteria to investigate the prevalence of metabolic syndrome (MetS) in Korea and its relationship with antipsychotic medications.

Methods

This multicenter, cross-sectional, and observational study included patients diagnosed with schizophrenia or schizoaffective disorder. Sixteen hospitals enrolled 845 patients aged 18 to 65 years prescribed any antipsychotic medication between August 2011 and August 2013. MetS was diagnosed using the criteria of the modified Adult Treatment Panel III of the National Cholesterol Education Program with the Korean abdominal obesity definition (waist circumference ≥85 cm in women, ≥90 cm in men).

Results

The prevalence of MetS in all patients was 36.5% and was significantly higher in men than women (men, 40.8%; women, 32.2%) and was significantly correlated with age [odds ratio (OR) 1.02] and duration of illness (OR 1.03). The prevalence of MetS across antipsychotic drugs in the major monotherapy group was as follows: 18.8% for quetiapine, 22.0% for aripiprazole, 33.3% for both amisulpride and paliperidone, 34.0% for olanzapine, 35% for risperidone, 39.4% for haloperidol, and 44.7% for clozapine.

Conclusion

The prevalence of MetS is very high in patients with schizophrenia or schizoaffective disorder. Screening and monitoring of MetS is also strongly recommended.

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Most cited references 35

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The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994.

Yong-Woo Park, Shankuan Zhu, Latha P. Palaniappan … (2003)

The metabolic syndrome is an important cluster of coronary heart disease risk factors with common insulin resistance. The extent to which the metabolic syndrome is associated with demographic and potentially modifiable lifestyle factors in the US population is unknown. Metabolic syndrome-associated factors and prevalence, as defined by Adult Treatment Panel III criteria, were evaluated in a representative US sample of 3305 black, 3477 Mexican American, and 5581 white men and nonpregnant or lactating women aged 20 years and older who participated in the cross-sectional Third National Health and Nutrition Examination Survey. The metabolic syndrome was present in 22.8% and 22.6% of US men and women, respectively (P =.86). The age-specific prevalence was highest in Mexican Americans and lowest in blacks of both sexes. Ethnic differences persisted even after adjusting for age, body mass index, and socioeconomic status. The metabolic syndrome was present in 4.6%, 22.4%, and 59.6% of normal-weight, overweight, and obese men, respectively, and a similar distribution was observed in women. Older age, postmenopausal status, Mexican American ethnicity, higher body mass index, current smoking, low household income, high carbohydrate intake, no alcohol consumption, and physical inactivity were associated with increased odds of the metabolic syndrome. The metabolic syndrome is present in more than 20% of the US adult population; varies substantially by ethnicity even after adjusting for body mass index, age, socioeconomic status, and other predictor variables; and is associated with several potentially modifiable lifestyle factors. Identification and clinical management of this high-risk group is an important aspect of coronary heart disease prevention.

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Increasing Prevalence of Metabolic Syndrome in Korea

Soo A Lim, Hayley Shin, Jung Han Song … (2011)

OBJECTIVE The number of people with metabolic syndrome is increasing worldwide, and changes in socioenvironmental factors contribute to this increase. Therefore, investigation of changes in metabolic syndrome and its components in South Korea, where rapid socioenvironmental changes have occurred in recent years, would be foundational in setting up an effective strategy for reducing this increasing trend. RESEARCH DESIGN AND METHODS We compared the prevalence and pattern of metabolic syndrome among participants in the Korean National Health and Nutrition Examination Surveys for 1998, 2001, 2005, and 2007. In each survey, stratified, multistage, probability–sampling designs and weighting adjustments were conducted to represent the entire Korean population. The revised National Cholesterol Education Program criteria were used as the definition of metabolic syndrome. All biochemical parameters were measured in a central laboratory. RESULTS A total of 6,907 (mean ± SE age 45.0 ± 0.2 years), 4,536 (45.5 ± 0.2), 5,373 (47.1 ± 0.2), and 2,890 (49.9 ± 0.3) Koreans over 20 years of age have participated in the studies in 1998, 2001, 2005, and 2007, respectively. The age-adjusted prevalence of metabolic syndrome increased significantly from 24.9% in 1998, 29.2% in 2001, and 30.4% in 2005 to 31.3% in 2007. Among the five components, the level of low HDL cholesterol increased the most, by 13.8% over the 10 years. Abdominal obesity and hypertriglyceridemia followed, with 8.7 and 4.9% increases, respectively. CONCLUSIONS Because dyslipidemia and abdominal obesity were major factors in increasing the prevalence of metabolic syndrome in Koreans for the past 10 years, lifestyle interventions should be conducted at the national level to reduce the burden and consequences of metabolic syndrome.

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The unhealthy lifestyle of people with schizophrenia.

J Birtwistle, Yvette Roe, Elaine C. Thompson … (1999)

Schizophrenia has a high natural mortality of a largely environmental aetiology. There is, however, little research about possible risk factors. This study measured the diet, cigarette and alcohol use, exercise and obesity of a cohort of people with schizophrenia and compared results to general population rates. Semi-structured interview using validated research instruments on 102 middle-aged subjects with a diagnosis of schizophrenia, living in the community. Results were compared to general population norms using standard statistical tests. The subjects ate a diet higher in fat and lower in fibre than the general population. They look little exercise but were not significantly more obese. They smoked heavily but drank less alcohol. Most differences remained significant after controlling for social class. People with schizophrenia have an unhealthy lifestyle, which probably contributes to the excess mortality of the disease. They are therefore an appropriate target group for health promotion interventions.

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Author and article information

Journal

Journal ID (nlm-ta): Psychiatry Investig

Journal ID (iso-abbrev): Psychiatry Investig

Journal ID (publisher-id): PI

Title: Psychiatry Investigation

Publisher: Korean Neuropsychiatric Association

ISSN (Print): 1738-3684

ISSN (Electronic): 1976-3026

Publication date (Print): January 2017

Publication date (Electronic): 29 December 2016

Volume: 14

Issue: 1

Pages: 44-50

Affiliations

[1 ]Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.

[2 ]Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

[3 ]Department of Psychiatry, College of Medicine, Hanyang University, Hanyang University Medical Center, Seoul, Republic of Korea.

[4 ]Department of Psychiatry, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea.

[5 ]Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea.

[6 ]Department of Psychiatry, Gil Medical Center, Gachon University School of Medicine, Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.

[7 ]Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea.

[8 ]Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.

[9 ]Department of Psychiatry & Behavioral Neuroscience, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Republic of Korea.

[10 ]Yongin Psychiatric Research Institute, Yongin Mental Hospital, Yongin, Republic of Korea.

[11 ]Department of Psychiatry, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.

[12 ]Department of Psychiatry, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea.

[13 ]Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea.

[14 ]Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea.

[15 ]Department of Psychiatry, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.

Author notes

Correspondence: Yeon Ho Joo, MD, PhD. Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, 88 Oylimpic-ro, Songpa-gu, Seoul 05505, Republic of Korea. Tel: +82-2-3010-3410, Fax: +82-2-485-8381, jooyh@ 123456amc.seoul.kr

Article

DOI: 10.4306/pi.2017.14.1.44

PMC ID: 5240463

SO-VID: f6978ce7-0bf6-42ab-88ad-65625073ac21

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 19 February 2016

Date revision received : 02 May 2016

Date accepted : 03 June 2016

Funding

Funded by: Korea Otsuka Pharmaceuticals;

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Prevalence of Metabolic Syndrome in Patients with Schizophrenia in Korea: A Multicenter Nationwide Cross-Sectional Study

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Abstract

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Most cited references 35

The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994.

Increasing Prevalence of Metabolic Syndrome in Korea

The unhealthy lifestyle of people with schizophrenia.

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Cited by 6

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