Abstract

BackgroundLifestyle factors, such as an unbalanced diet and lack of physical activity, may affect the prevalence of metabolic syndrome (MetS) in schizophrenic patients. The aim of this study was to compare the MetS prevalence between inpatients and outpatients among schizophrenic population in Japan.MethodsWe recruited inpatients (n = 759) and outpatients (n = 427) with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of schizophrenia or schizoaffective disorder from 7 psychiatric hospitals using a cross-sectional design. MetS prevalence was assessed using three different definitions, including the adapted National Cholesterol Education Program Adult Treatment Panel (ATP III-A).ResultsThe overall MetS prevalences based on the ATP III-A definition were 15.8% in inpatients and 48.1% in outpatients. In a logistic regression model with age and body mass index as covariates, being a schizophrenic outpatient, compared to being a schizophrenic inpatient, was a significant independent factor (odds ratio = 3.66 for males, 2.48 for females) in the development of MetS under the ATP III-A definition. The difference in MetS prevalence between inpatients and outpatients was observed for all age groups in males and for females over 40 years of age.ConclusionsOutpatients with schizophrenia or schizoaffective disorder in Japan had a high prevalence of MetS compared to inpatients. MetS in schizophrenic outpatients should be carefully monitored to minimize the risks. A change of lifestyle might improve MetS in schizophrenic patients.

Highlights

  • A high prevalence of metabolic syndrome (MetS) has been reported among schizophrenic patients [1,2,3]

  • Because abdominal obesity is widely recognized as a measure of metabolic abnormality, the International Diabetes Federation (IDF) established a definition that stressed the importance of waist circumference [10]

  • An association between gender and MetS prevalence was significant based on the Japan Society for the Study of Obesity (JASSO) and IDF definitions (JASSO: c2 = 16.03, df = 1, P < 0.001, IDF: c2 = 4.04, df = 1, P < 0.05) but was not significant based on the ATP III-A definition (c2 = 1.49, df = 1, P = 0.22)

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Summary

Introduction

A high prevalence of metabolic syndrome (MetS) has been reported among schizophrenic patients [1,2,3]. Based on an area of 100 cm of intra-abdominal fat, the cut-off value for waist circumference is 85 cm for males and 90 cm for females under the JASSO definition [15]. The Japanese Committee of the Criteria for Metabolic Syndrome established the JASSO definition, there has been controversy concerning the effective cut-off value for waist circumference [16]. Lifestyle factors, such as an unbalanced diet and lack of physical activity, may affect the prevalence of metabolic syndrome (MetS) in schizophrenic patients.

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