The risk for abdominal obesity is more than four times higher in patients with multi-episode schizophrenia compared to the general population, according to new meta-analytic research.
These individuals are also at greater risk for other cardio-metabolic problems — such as low levels of high-density lipoprotein (HDL) cholesterol, metabolic syndrome, hypertriglyceridemia and diabetes.
For the study, researchers conducted a meta-analysis of 136 studies — involving 185,606 patients with schizophrenia — 28 of which provided data on nearly 3,900,000 population controls matched for age and gender. This study is one of the largest ever conducted on people with schizophrenia.
The findings reveal that patients with multi-episode schizophrenia were 4.43 times more likely to have abdominal obesity than controls.
Furthermore, the risk for low HDL cholesterol, metabolic syndrome, and hypertriglyceridemia were more than doubled, at 2.35, 2.35, and 2.73, respectively.
The risk for diabetes was nearly double in these patients, and the risk for hypertension was increased 1.36-fold.
With the exception of diabetes and hypertension, the risk for these conditions in multi-episode schizophrenia patients was also significantly increased versus that for first-episode or drug-naïve patients.
Schizophrenia researchers have warned that weight gain occurs in up to 40 percent of patients taking medications called second-generation or atypical antipsychotic medications, which have been found effective in controlling major symptoms of schizophrenia.
Given the high rates of metabolic problems, the researchers propose that schizophrenia patients should, at the very least, have their waist circumference measured regularly, and, ideally, also their fasting glucose, triglyceride, HDL cholesterol, and hemoglobin A1C levels.
They also suggest routine screening of cardiovascular risk factors at key stages to create a risk profile for patients that takes into account their personal and family history.
“This risk profile should afterwards be used as a basis for ongoing monitoring, treatment selection and management,” wrote the researchers in World Psychiatry.
Lead researcher Davy Vancampfort, Ph.D., of the University Psychiatric Centre KU Leuven and colleagues believe it is important to educate schizophrenia patients and their family members about the increased risk for cardio-metabolic abnormalities and ways to lessen it.
According to the researchers, many schizophrenia patients are either unaware of the need to make appropriate lifestyle changes or do not possess the knowledge and skills to do so.
The findings support guidelines from the World Psychiatric Association recommending physical health screening and monitoring in patients with schizophrenia. And they further emphasize the need for patients with schizophrenia and their family members to be educated about the possibility of cardio-metabolic risk.
Source: World Psychiatry