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Lee JS, Kwon JS, Kim D, Kim SW, Kim JJ, Kim JH, Nam HJ, Ryu S, Park IH, An SK, Oh HS, Won S, Lee K, Lee KY, Lee SH, Lee YS, Yi JS, Hong KS, Joo YH. Prevalence of Metabolic Syndrome in Patients with Schizophrenia in Korea: A Multicenter Nationwide Cross-Sectional Study. Psychiatry Investig 2017; 14:44-50. [PMID: 28096874 PMCID: PMC5240463 DOI: 10.4306/pi.2017.14.1.44] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 05/02/2016] [Accepted: 06/03/2016] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE We designed a nationwide study with limited exclusion criteria to investigate the prevalence of metabolic syndrome (MetS) in Korea and its relationship with antipsychotic medications. METHODS This multicenter, cross-sectional, and observational study included patients diagnosed with schizophrenia or schizoaffective disorder. Sixteen hospitals enrolled 845 patients aged 18 to 65 years prescribed any antipsychotic medication between August 2011 and August 2013. MetS was diagnosed using the criteria of the modified Adult Treatment Panel III of the National Cholesterol Education Program with the Korean abdominal obesity definition (waist circumference ≥85 cm in women, ≥90 cm in men). RESULTS The prevalence of MetS in all patients was 36.5% and was significantly higher in men than women (men, 40.8%; women, 32.2%) and was significantly correlated with age [odds ratio (OR) 1.02] and duration of illness (OR 1.03). The prevalence of MetS across antipsychotic drugs in the major monotherapy group was as follows: 18.8% for quetiapine, 22.0% for aripiprazole, 33.3% for both amisulpride and paliperidone, 34.0% for olanzapine, 35% for risperidone, 39.4% for haloperidol, and 44.7% for clozapine. CONCLUSION The prevalence of MetS is very high in patients with schizophrenia or schizoaffective disorder. Screening and monitoring of MetS is also strongly recommended.
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Affiliation(s)
- Jung Sun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Daeho Kim
- Department of Psychiatry, College of Medicine, Hanyang University, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jae-Jin Kim
- Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Jong-Hoon Kim
- Department of Psychiatry, Gil Medical Center, Gachon University School of Medicine, Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Hee Jung Nam
- Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Il Ho Park
- Department of Psychiatry & Behavioral Neuroscience, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Hong-Seok Oh
- Yongin Psychiatric Research Institute, Yongin Mental Hospital, Yongin, Republic of Korea
| | - Seunghee Won
- Department of Psychiatry, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Kanguk Lee
- Department of Psychiatry, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Kyu Young Lee
- Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Yu Sang Lee
- Yongin Psychiatric Research Institute, Yongin Mental Hospital, Yongin, Republic of Korea
| | - Jung-Seo Yi
- Department of Psychiatry, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Kyung Sue Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yeon Ho Joo
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Kang YE, Kim JM, Joung KH, Lee JH, You BR, Choi MJ, Ryu MJ, Ko YB, Lee MA, Lee J, Ku BJ, Shong M, Lee KH, Kim HJ. The Roles of Adipokines, Proinflammatory Cytokines, and Adipose Tissue Macrophages in Obesity-Associated Insulin Resistance in Modest Obesity and Early Metabolic Dysfunction. PLoS One 2016; 11:e0154003. [PMID: 27101398 PMCID: PMC4839620 DOI: 10.1371/journal.pone.0154003] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/22/2016] [Indexed: 12/15/2022] Open
Abstract
The roles of adipokines, proinflammatory cytokines, and adipose tissue macrophages in obesity-associated insulin resistance have been explored in both animal and human studies. However, our current understanding of obesity-associated insulin resistance relies on studies of artificial metabolic extremes. The purpose of this study was to explore the roles of adipokines, proinflammatory cytokines, and adipose tissue macrophages in human patients with modest obesity and early metabolic dysfunction. We obtained omental adipose tissue and fasting blood samples from 51 females undergoing gynecologic surgery. We investigated serum concentrations of proinflammatory cytokines and adipokines as well as the mRNA expression of proinflammatory and macrophage phenotype markers in visceral adipose tissue using ELISA and quantitative RT-PCR. We measured adipose tissue inflammation and macrophage infiltration using immunohistochemical analysis. Serum levels of adiponectin and leptin were significantly correlated with HOMA-IR and body mass index. The levels of expression of MCP-1 and TNF-α in visceral adipose tissue were also higher in the obese group (body mass index ≥ 25). The expression of mRNA MCP-1 in visceral adipose tissue was positively correlated with body mass index (r = 0.428, p = 0.037) but not with HOMA-IR, whereas TNF-α in visceral adipose tissue was correlated with HOMA-IR (r = 0.462, p = 0.035) but not with body mass index. There was no obvious change in macrophage phenotype or macrophage infiltration in patients with modest obesity or early metabolic dysfunction. Expression of mRNA CD163/CD68 was significantly related to mitochondrial-associated genes and serum inflammatory cytokine levels of resistin and leptin. These results suggest that changes in the production of inflammatory biomolecules precede increased immune cell infiltration and induction of a macrophage phenotype switch in visceral adipose tissue. Furthermore, serum resistin and leptin have specific roles in the regulation of adipose tissue macrophages in patients with modest obesity or early metabolic dysfunction.
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Affiliation(s)
- Yea Eun Kang
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ji Min Kim
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Kyong Hye Joung
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ju Hee Lee
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Bo Ram You
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Min Jeong Choi
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Min Jeong Ryu
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Young Bok Ko
- Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Min A. Lee
- Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Junguee Lee
- Department of Pathology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Bon Jeong Ku
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of internal medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Minho Shong
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of internal medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Ki Hwan Lee
- Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Jin Kim
- Department of Internal medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
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