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

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초록

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.

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.

참고문헌 (50)

  1. Brown S, "Causes of the excess mortality of schizophrenia", Br J Psychiatry, 177, pp.212~217 (2000)
  2. Osby U, "Mortality and causes of death in schizophrenia in Stockholm county, Sweden", Schizophr Res, 45, pp.21~28 (2000)
  3. Dixon L, "Prevalence and correlates of diabetes in national schizophrenia samples", Schizophr Bull, 26, pp.903~912 (2000)
  4. McCreadie R, "Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study", BMJ, 317, pp.784~785 (1998)
  5. Brown S, "The unhealthy lifestyle of people with schizophrenia", Psychol Med, 29, pp.697~701 (1999)
  6. De Hert M, "Metabolic and cardiovascular adverse effects associated with antipsychotic drugs", Nat Rev Endocrinol, 8, pp.114~126 (2011)
  7. Leucht S, "A meta-analysis of head-to-head comparisons of second-generation antipsychotics in the treatment of schizophrenia", Am J Psychiatry, 166, pp.152~163 (2009)
  8. De Hert M, "Metabolic syndrome in people with schizophrenia : a review", World Psychiatry, 8, pp.15~22 (2009)
  9. Sernyak MJ, "Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia", Am J Psychiatry, 159, pp.561~566 (2002)
  10. Bresee LC, "Prevalence of cardiovascular risk factors and disease in people with schizophrenia : a population-based study", Schizophr Res, 117, pp.75~82 (2010)
  11. Saari KM, "A 4-fold risk of metabolic syndrome in patients with schizophrenia : the Northern Finland 1966 Birth Cohort study", J Clin Psychiatry, 66, pp.559~563 (2005)
  12. McEvoy JP, "Prevalence of the metabolic syndrome in patients with schizophrenia : baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness(CATIE)schizophrenia trial and comparison with national estimates from NHANES III", Schizophr Res, 80, pp.19~32 (2005)
  13. Lee NY, "The prevalence of metabolic syndrome in Korean patients with schizophrenia receiving monotherapies with aripiprazole, olanzapine or risperidone", Prog Neuropsychopharmacol Biol Psychiatry, 35, pp.1273~1278 (2011)
  14. Schorr SG, "The incidence of metabolic syndrome and its reversal in a cohort of schizophrenic patients followed for one year", J Psychiatr Res, 43, pp.1106~1111 (2009)
  15. De Hert MA, "Prevalence of the metabolic syndrome in patients with schizophrenia treated with antipsychotic medication", Schizophr Res, 83, pp.87~93 (2006)
  16. Srisurapanont M, "Metabolic syndrome in Thai schizophrenic patients : a naturalistic one-year follow-up study", BMC Psychiatry, 7, pp.14~ (2007)
  17. Sugawara N, "Prevalence of metabolic syndrome among patients with schizophrenia in Japan", Schizophr Res, 123, pp.244~250 (2010)
  18. Ford ES, "Prevalence of the metabolic syndrome among US adults : findings from the third national health and nutrition examination survey", JAMA, 287, pp.356~359 (2002)
  19. Eckel RH, "The metabolic syndrome", Lancet, 365, pp.1415~1428 (2005)
  20. Park YW, "The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994", Arch Intern Med, 163, pp.427~436 (2003)
  21. Lee SY, "Appropriate waist circumference cutoff points for central obesity in Korean adults", Diabetes Res Clin Pract, 75, pp.72~80 (2007)
  22. Gardner DM, "International consensus study of antipsychotic dosing", Am J Psychiatry, 167, pp.686~693 (2010)
  23. Huang MC, "Prevalence of metabolic syndrome among patients with schizophrenia or schizoaffective disorder in Taiwan", Acta psychiatr Scand, 120, pp.274~280 (2009)
  24. Bai YM, "Association of adiponectin and metabolic syndrome among patients taking atypical antipsychotics for schizophrenia : a cohort study", Schizophr Res, 111, pp.1~8 (2009)
  25. 오경원, "한국 소아청소년의 비만 유병률 추이: 1997년과 2005년 비교", Korean Journal of Pediatrics, 51(9), pp.950~955 (2008), 대한소아과학회
  26. Lim S, "Increasing prevalence of metabolic syndrome in Korea : the Korean National Health and Nutrition Examination Survey for 1998-2007", Diabetes Care, 34, pp.1323~1328 (2011)
  27. Deuschle M, "Assessment of cardiovascular disease risk in patients with schizophrenia spectrum disorders in German psychiatric hospitals : results of the pharmacoepidemiologic CATS study", Soc Psychiatry Psychiatr Epidemiol, 48, pp.1283~1288 (2013)
  28. Tan CE, "Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians?", Diabetes Care, 27, pp.1182~1186 (2004)
  29. Eberly LE, "Metabolic syndrome : risk factor distribution and 18-year mortality in the multiple risk factor intervention trial", Diabetes Care, 29, pp.123~130 (2006)
  30. de Leon J, "Schizophrenia and smoking : an epidemiological survey in a state hospital", Am J Psychiatry, 152, pp.453~455 (1995)
  31. de Leon J, "A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors", Schizophr Res, 76, pp.135~157 (2005)
  32. Amani R, "Is dietary pattern of schizophrenia patients different from healthy subjects?", BMC Psychiatry, 7, pp.15~ (2007)
  33. Meyer JM, "The effects of antipsychotic therapy on serum lipids : a comprehensive review", Schizophr Res, 70, pp.1~17 (2004)
  34. De Hert M, "Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia : a retrospective chart review", Schizophr Res, 101, pp.295~303 (2008)
  35. Meyer JM, "Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia Trial : prospective data from phase 1", Schizophr Res, 101, pp.273~286 (2008)
  36. Wampers M, "Differential effects of olanzapine and risperidone on plasma adiponectin levels over time : results from a 3-month prospective open-label study", Eur Neuropsychopharmacol, 22, pp.17~26 (2012)
  37. Rummel-Kluge C, "Head-to-head comparisons of metabolic side effects of second generation antipsychotics in the treatment of schizophrenia : a systematic review and meta-analysis", Schizophr Res, 123, pp.225~233 (2010)
  38. van Winkel R, "Major changes in glucose metabolism, including new-onset diabetes, within 3 months after initiation of or switch to atypical antipsychotic medication in patients with schizophrenia and schizoaffective disorder", J Clin Psychiatry, 69, pp.472~479 (2008)
  39. L’Italien GJ, "Comparison of metabolic syndrome incidence among schizophrenia patients treated with aripiprazole versus olanzapine or placebo", J Clin Psychiatry, 68, pp.1510~1516 (2007)
  40. Lin CC, "Improved body weight and metabolic outcomes in overweight or obese psychiatric patients switched to amisulpride from other atypical antipsychotics", J Clin Psychopharmacol, 29, pp.529~536 (2009)
  41. Simon V, "Are weight gain and metabolic side effects of atypical antipsychotics dose dependent? A literature review", J Clin Psychiatry, 70, pp.1041~1050 (2009)
  42. Osborn DP, "Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the United Kingdom’s General Practice Research Database", Arch Gen Psychiatry, 64, pp.242~249 (2007)
  43. Eder U, "Association of olanzapine-induced weight gain with an increase in body fat", Am J Psychiatry, 158, pp.1719~1722 (2001)
  44. Chen JJ, "Risperidone and olanzapine versus another first generation antipsychotic in patients with schizophrenia inadequately responsive to first generation antipsychotics", Pharmacopsychiatry, 45, pp.64~71 (2012)
  45. McIntyre RS, "The association between conventional antidepressants and the metabolic syndrome : a review of the evidence and clinical implications", CNS Drugs, 24, pp.741~753 (2010)
  46. Bhuvaneswar CG, "Adverse endocrine and metabolic effects of psychotropic drugs : selective clinical review", CNS Drugs, 23, pp.1003~1021 (2009)
  47. Hahn MK, "Topiramate augmentation in clozapine-treated patients with schizophrenia : clinical and metabolic effects", J Clin Psychopharmacol, 30, pp.706~710 (2010)
  48. Hahn MK, "Topiramate in schizophrenia : a review of effects on psychopathology and metabolic parameters", Clin Schizophr Relat Psychoses, 6, pp.186~196 (2013)
  49. Correll CU, "Endocrine and metabolic adverse effects of psychotropic medications in children and adolescents", J Am Acad Child Adolesc Psychiatry, 45, pp.771~791 (2006)
  50. The Epidemiological Survey of Mental Disorders in Korea 2011, "Cho M", Ministry of Health and Welfare, 1~439 (2012)

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