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Prevalence of metabolic syndrome in drug-naive patients with schizophrenia

Dinesh Singh Rathor, Sudhir Kumar, Deshbandhu Tiwari, Rakesh Kumar Jain, Anil Kumar Sisodia.

Background: Asians are physiologically and genetically at a higher risk of metabolic syndrome. India is at the top with highest prevalence of metabolic syndrome. In recent times, it is established that antipsychotics, especially second generations, increases the risk of metabolic syndrome – which could be an already existing co-morbidity of schizophrenia in drug-naïve patients.

Objectives: This was a hospital-based cross-sectional study with the aim to know the prevalence of metabolic syndrome in the antipsychotic naïve schizophrenia patients.

Material and Methods: Following pre-decided inclusion and exclusion criteria, 65 patients were selected and assessed using socio-demographic and clinical data sheet, physical examinations like blood pressure, waist circumferences, and biochemical with normal values prescribed by API.

Results: The prevalence of metabolic syndrome in patients with schizophrenia was 15.6% but major concern was the higher percentage of subsyndromal metabolic syndrome 1 and 2 (SMS1 and SMS2, 46.2% and 32.3%, respectively). Hypertension topped the list (65%) followed by low ‘high-density lipoproteins’ (HDL) (50%). Gender did not appear to be affecting the metabolic syndrome in schizophrenia but metabolic syndrome (MS) was commoner in those with age > 35 years while SMS was commoner in those with age < 35 years.

Conclusion: Even in drug-naïve schizophrenic, metabolic syndrome is more often full blown than none at all – sub-syndromal status is the commonest. Triacylglyceride (TAG) and fasting blood sugar (FBS) impairments are rare (< 5% occurrence) unless full blown MS. HDL anomaly is commoner in SMS1 while waist circumference (WC) and blood pressure (BP) anomaly is commoner in SMS2. Age appears to be the only independent factor in the prevalence (but not the duration of the disease). Diagnosis and awareness about these co-morbidities can help primary, secondary or tertiary prevention.

Key words: Schizophrenia, metabolic syndrome, subsyndromal, SMS1, SMS2

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