Impact of the metabolic syndrome on severe mental disorders

Clinical Management of Metabolic Syndrome Among the Population Attending Geriatric Outpatient Clinics in Qatar

INTRODUCTION

Research on the clinical management of metabolic syndrome (MetS) among older individuals in Qatar is limited. This study aimed to determine the clinical management of MetS and associated risk factors.

METHODS

A retrospective study was conducted to examine the risk factors for MetS (hypertension, diabetes mellitus, obesity, and hyperlipidemia) among patients aged ≥ 60 years who visited geriatric outpatient clinics in Rumailah Hospital, Doha, Qatar between November 1, 2016, and November 1, 2018.

RESULTS

The mean age of the patients was 70.1 years, and 50% were male. Of the study population, 97% had MetS with a 95% confidence interval (95.3-98.7). In addition, 45.5% of the patients were obese, 97.75% had diabetes mellitus, and 98.25% had hypertension. The most commonly prescribed medications for treatment included amlodipine for hypertension, metformin for diabetes mellitus, rosuvastatin for lipid reduction, and bisoprolol for cardiovascular management.

CONCLUSION

This study found that MetS is common among the population attending geriatric outpatient clinics in Qatar. The majority of these individuals had high rates of diabetes, hypertension, and dyslipidemia. The early identification of at-risk patients through exercise programs may also delay or reverse the risks associated with MetS. More research, especially prospective and population-based studies, is required to improve preventative efforts and optimize treatment options for metabolic syndrome in older persons in Qatar.

Influence of Lifestyle Factors on Metabolic Syndrome in Psychiatric Patients Attending a Community Mental Health Setting: A Cross-sectional Study

Background

Metabolic syndrome (MetS) is a concern in psychiatric patients. We aimed to study the influence of the modifiable lifestyle factors on MetS in adult psychiatric patients along with associated clinical factors and quality of life.

Methods

Factors such as diet (Healthy Eating Index), exercise, substance use, cardiovascular risk (QRISK), illness severity (Clinical Global Impression), medications, adverse events (Systematic Monitoring of Adverse Events Related to Treatments), and quality of life (Recovering Quality of Life Scale) were assessed along with clinical components for MetS in 323 psychiatric patients receiving routine care and monitoring in a Community Mental Health Team.

Results

MetS was present in 50.5% (95% CI: 45.0-55.9). It was significantly associated with higher age, duration of mental illness, body mass index (BMI), QTc, QRISK, and antipsychotic drugs. In logistic regression, age, QTc, QRISK, and BMI remained significantly linked to MetS. Patients with or without MetS were comparable in their lifestyle factors such as diet, exercise, and substance use, along with the family history of metabolic disorders, age at onset of mental illness, duration of antipsychotic medication, side effects, psychiatric diagnoses, and quality of life. However, many patients with or without MetS had poorer diet and physical inactivity, indicating scope for interventions.

Conclusions

Around half of the psychiatric patients had MetS, and modifiable lifestyle factors did not differentiate individuals with or without MetS. The need for further research on the prevention and management of MetS in psychiatric patients is highlighted.

Cardiovascular risk factors and metabolic syndrome in patients treated with long-acting injectables antipsychotics: a retrospective study

The present cross-sectional, retrospective study aimed to assess the prevalence of cardiovascular disease (CVD) risk factors and metabolic syndrome in a sample of psychiatric patients treated with long-acting injectable antipsychotics (LAIs). The clinical charts of 120 patients, mainly diagnosed with schizophrenia (30.0%), schizoaffective disorder (15.0%), and bipolar disorder (13.3%) on LAIs therapy - initiated in the period from 2013 to 2019 and lasting at least one year - were retrospectively reviewed and related socio-demographic, clinical and laboratory variables were collected. The 70.8% of patients were treated with first-generation LAIs, and the remaining 29.2% with second-generation LAIs. The overall sample showed low compliance in performing the required exams and evaluations related to CVD risk factors. The prevalence of metabolic syndrome was 30.8%, and, considering specific CVD risk factors, 55% of the total sample reported abdominal obesity, 43.3% arterial hypertension, 41.7% low HDL-cholesterol, 25.8% hypertriglyceridemia, and 20.8% fasting hyperglycemia. Lastly, 6.7% showed prolonged corrected QT (QTc) interval at the ECG. Patients treated with LAIs should be regularly monitored for metabolic changes and CVD risk factors. Metabolic changes rapidly develop after initiating an antipsychotic therapy and these often involve parameters, that can be easily recorded in an outpatient setting (e.g. abdominal obesity and hypertension).