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
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
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DOI：
10.1016/j.schres.2005.07.014
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发表时间：
2005-12-01
影响因子：
4.5
通讯作者：
Lieberman, JA
中科院分区：
文献类型：
--
作者：
McEvoy, JP;Meyer, JM;Lieberman, JA
心血管疾病的一个重要危险因素是代谢综合征（MS），但其在美国精神分裂症患者中的患病率数据有限。使用来自临床抗精神病药物干预有效性试验（CATIE）精神分裂症试验的基线数据，基于国家胆固醇教育计划（NCEP）标准进行MS患病率评估，并且还使用100 mg/dl的空腹血糖阈值（AHA）。有足够的人体测量数据，使用抗高血压药物，降糖药物或胰岛素的数据，以及从最后一餐开始的空腹血糖和血脂值> 8 It的受试者被纳入分析。使用随机选择的样本进行比较分析NHANES III匹配I：I的基础上的年龄，性别和种族/ethnication.Results：1460 CATIE基线受试者，689符合分析标准。采用NCEP和AHA标准，MS患病率分别为40.9%和42.7%。在女性中，使用NCEP和AHA标准的比例分别为51.6%和54.2%，而男性分别为36.0%（p =.0002）和36.6%（p =.0003）。73.4%的女性（包括非空腹受试者）符合腰围标准，而男性为36.6%。在以年龄、种族和民族为协变量的逻辑回归模型中，CATIE男性比NHANES匹配样本患MS的可能性高138%，CATIE女性比NHANES对应样本患MS的可能性高251%。即使在控制身体质量指数的差异，CATIE男性仍然有85%的可能性比NHANES男性样本MS，和CATIE女性137%的可能性比女性在NHANES.Conclusions MS：代谢综合征是非常普遍的，在美国精神分裂症患者和心血管疾病的风险，特别是女性的巨大来源。临床上必须注意监测这种综合征，并尽量减少与抗精神病药物治疗相关的代谢风险。(c)2005 Elsevier B. V.保留所有权利。
One important risk factor for cardiovascular disease is the metabolic syndrome (MS), yet limited data exist on its prevalence in US patients with schizophrenia.Methods: Using baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial, assessment of MS prevalence was performed based on National Cholesterol Education Program (NCEP) criteria, and also using a fasting glucose threshold of 100 mg/dl (AHA). Subjects with sufficient anthropometric data, data on use of antihypertensives, hypoglycemic medications or insulin, and fasting glucose and lipid values > 8 It from last meal were included in the analysis. Comparative analyses were performed using a randomly selected sample from NHANES III matched I : I on the basis of age, gender and race/ethnicity.Results: Of 1460 CATIE baseline subjects, 689 met analysis criteria. MS prevalence was 40.9% and 42.7%, respectively using the NCEP and AHA derived criteria. In females it was 51.6% and 54.2% using the NCEP and AHA criteria, compared to 36.0% (p =.0002) and 36.6% (p =.0003), respectively for males. 73.4% of all females (including nonfasting subjects) met the waist circumference criterion compared to 36.6% of males. In a logistic regression model with age, race and ethnicity as covariates, CATIE males were 138% more likely to have MS than the NHANES matched sample, and CATIE females 251% more likely than their NHANES counterparts. Even when controlling for differences in body mass index, CATIE males were still 85% more likely to have MS than the NHANES male sample, and CATIE females 137% more likely to have MS than females in NHANES.Conclusions: The metabolic syndrome is highly prevalent in US schizophrenia patients and represents an enormous source of cardiovascular risk, especially for women. Clinical attention must be given to monitoring for this syndrome, and minimizing metabolic risks associated with antipsychotic treatment. (c) 2005 Elsevier B.V. All rights reserved.