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Metabolic syndrome in outpatients receiving antipsychotic therapy in routine clinical practice: A cross-sectional assessment of a primary health care database

Published online by Cambridge University Press:  16 April 2020

Antoni Sicras-Mainar*
Affiliation:
Planning Directorate, Badalona Serveis Assistencials SA, Gaietá Soler, 8-entresuelo, 08911Badalona (Barcelona), Spain
Milagrosa Blanca-Tamayo
Affiliation:
Department of Psychiatry, Badalona Serveis Assistencials, Badalona (Barcelona), Spain
Javier Rejas-Gutiérrez
Affiliation:
Department of Health Outcomes Research, Medical Unit, Pfizer España, Alcobendas (Madrid), Spain
Ruth Navarro-Artieda
Affiliation:
Medical Documentation Service. Germans Trías i Pujol Hospital, Badalona (Barcelona), Spain
*
*Corresponding author. Tel.: +34 93 507 2684. E-mail address: asicras@bsa.gs (A. Sicras-Mainar).
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Abstract

Objective

To determine the prevalence of metabolic syndrome (MS) in outpatients treated with antipsychotics included in a primary-health-care database.

Methods

A cross-sectional study was carried out assessing an administrative outpatients claim-database from 5 primary-health-centers. Subjects on antipsychotics for more than 3 months were included. The control group was formed by the outpatients included in the database without exposition to any antipsychotic drugs. MS was defined according to the modified NCEP-ATP III criteria, and required confirmation of at least 3 of the 5 following components: body mass index >28.8 kg/m2, triglycerides >150 mg/ml, HDL-cholesterol <40 mg/ml (men)/<50 mg/ml (women), blood pressure >130/85 mmHg, and fasting serum glucose >110 mg/dl.

Results

We identified 742 patients [51.5% women, aged 55.1 (20.7) years] treated with first- or second-generation antipsychotics during 27.6 (20.3) months. Controls were 85.286 outpatients [50.5% women, aged 45.5 (17.7) years]. MS prevalence was significantly higher in subjects on antipsychotics: 27.0% (95% CI, 23.8–30.1%) vs. 14.4% (14.1–14.6%); age- and sex-adjusted OR = 1.38 (1.16–1.65, P < 0.001). All MS components, except high blood pressure, were significantly more prevalent in the antipsychotic group, particularly body mass index >28.8 kg/m2: 33.0% (29.6–36.4%) vs. 17.8% (17.6–18.1%), adjusted OR = 1.63 (1.39–1.92, P < 0.001), and low HDL-cholesterol levels: 48.4% (44.8–52.0%) vs. 29.3% (29.0–29.6%); adjusted OR = 1.65 (1.42–1.93, P < 0.001). Compared with the reference population, subjects with schizophrenia or bipolar disorder (BD), but not dementia, showed a higher prevalence of MS.

Conclusions

Compared with the general outpatient population, the prevalence of MS was significantly higher in patients with schizophrenia or BD treated with antipsychotics.

Information

Type
Original articles
Copyright
Copyright © Elsevier Masson SAS 2008

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