Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis.
Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis.
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DOI：
10.3389/fendo.2021.769309
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发表时间：
2021
影响因子：
5.2
通讯作者：
Zavala GA
中科院分区：
文献类型：
--
作者：
Afzal M;Siddiqi N;Ahmad B;Afsheen N;Aslam F;Ali A;Ayesha R;Bryant M;Holt R;Khalid H;Ishaq K;Koly KN;Rajan S;Saba J;Tirbhowan N;Zavala GA
1)确定重度精神疾病（SMI）患者超重和肥胖的汇总患病率，总体和按SMI类型、地理区域和数据收集年份分类; 2）评估SMI患者与普通人群相比超重和肥胖的可能性。检索PubMed、Medline、EMBASE和PsycINFO数据库，以确定评估SMI成人肥胖患病率的观察性研究。筛选、数据提取和偏倚风险评估由两位共同作者独立进行。计算了重度精神病患者与普通人群相比，超重和肥胖合并患病率以及肥胖合并几率的随机效应估计值。对SMI类型、环境、抗精神病药物、世界地区、国家收入分类、数据收集日期和性别进行亚组分析。我们评估了发表偏倚，并进行了一系列敏感性分析，排除了偏倚风险高、样本量小和未报告WHO分类肥胖的研究。纳入了来自43个国家的120项研究，大多数来自高收入国家。SMI患者的肥胖患病率为25.9%（95% CI）。= 23.3-29.1），超重和肥胖合并患病率为60.1%（95% C.I. = 55.8-63.1）。撒哈拉以南非洲（13.0%，95% C.I.）= 6.7-25.1）和南亚（17.7%，95%C.I. = 10.5-28.5）的肥胖患病率最低，而北非和中东（35.8%，95%C.I. = 23.8-44.8）报告的患病率最高。患有SMI的人的可能性为3.04（95% CI）。= 2.42-3.82），但超重患病率无差异。女性精神分裂症患者为1.44（95% C.I. = 1.25-1.67）倍，更有可能比男性精神分裂症患者生活肥胖;然而，没有发现性别差异，在那些与双相情感障碍。与一般人群相比，SMI患者的患病率和肥胖几率明显较高。这可能导致这一群体的身体健康状况和死亡率非常高。世界各地的SMI患者可能会从减少和预防肥胖的干预措施中受益。
1) To determine the pooled prevalence of overweight and obesity in people with severe mental illness (SMI), overall and by type of SMI, geographical region, and year of data collection; and 2) to assess the likelihood of overweight and obesity, in people with SMI compared with the general population. PubMed, Medline, EMBASE, and PsycINFO databases were searched to identify observational studies assessing the prevalence of obesity in adults with SMI. Screening, data extraction and risk of bias assessments were performed independently by two co-authors. Random effect estimates for the pooled prevalence of overweight and obesity and the pooled odds of obesity in people with SMI compared with the general population were calculated. Subgroup analyses were conducted for types of SMI, setting, antipsychotic medication, region of the world, country income classification, date of data collection and sex. We assessed publication bias and performed a series of sensitivity analyses, excluding studies with high risk of bias, with low sample size and those not reporting obesity according to WHO classification. 120 studies from 43 countries were included, the majority were from high income countries. The pooled prevalence of obesity in people with SMI was 25.9% (95% C.I. = 23.3-29.1) and the combined pooled prevalence of overweight and obesity was 60.1% (95% C.I. = 55.8-63.1). Sub-Saharan Africa (13.0%, 95%C.I. = 6.7-25.1) and South Asia (17.7%, 95%C.I. = 10.5-28.5) had the lowest prevalence of obesity whilst North Africa and the Middle East (35.8%, 95%C.I. = 23.8-44.8) reported the highest prevalence. People with SMI were 3.04 more likely (95% C.I. = 2.42-3.82) to have obesity than the general population, but there was no difference in the prevalence of overweight. Women with schizophrenia were 1.44 (95% C.I. = 1.25-1.67) times more likely than men with schizophrenia to live with obesity; however, no gender differences were found among those with bipolar disorder. People with SMI have a markedly high prevalence and higher odds of obesity than the general population. This may contribute to the very high prevalence of physical health conditions and mortality in this group. People with SMI around the world would likely benefit from interventions to reduce and prevent obesity.
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