Physical health in mental illness: psychiatry's shared responsibility

Prevalence and predictors of metabolic syndrome among patients attending an outpatient clozapine clinic in Australia

OBJECTIVE

This study aimed to determine the prevalence and predictors of metabolic syndrome in an outpatient clozapine clinic in Australia.

METHODS

Metabolic syndrome is a cluster of some of the most dangerous cardiovascular risk factors, and its high prevalence in people with mental illness has been demonstrated. Patients attending a clozapine clinic were screened for the following: age, gender, ethnicity, waist circumference, blood pressure, high-density lipoprotein level, low-density lipoprotein level, blood sugar levels, total cholesterol level, triglycerides level, weight, body mass index, insulin resistance level, length of time on clozapine, clozapine dose, smoking status, family history of diabetes and cardiovascular disease, and personal history of polycystic ovarian syndrome. All the variables that were found to be significantly associated with metabolic syndrome were entered into a multivariate logistic regression analysis.

RESULTS

Seventy-three patients were screened for metabolic syndrome using the International Diabetes Federation's (2007) definition. Forty-five (61.6%) patients met the criteria for the syndrome. Increased blood sugar level, high diastolic blood pressure, older age, increased waist circumference, raised triglycerides level, and higher body mass index emerged as significant predictors of metabolic syndrome in the sample.

CONCLUSIONS

This study adds further support for the systematic screening for metabolic syndrome in patients receiving clozapine. The need for intervention programs which screen for and address the modifiable risk factors of metabolic syndrome is discussed.