Subthreshold metabolic syndrome common in drug-naïve schizophrenia patients

By Mark Cowen, Senior medwireNews Reporter

Around 1 in 10 antipsychotic-naïve Indian patients with schizophrenia meet full criteria for the metabolic syndrome, but a significantly larger proportion have subthreshold metabolic syndrome, researchers report.

Indeed, Sandeep Grover and colleagues from the Postgraduate Institute of Medical Education and Research in Chandigarh, India, found that 41.3% of antipsychotic-naïve schizophrenia patients had one of the five components of the metabolic syndrome and 30.4% had two.

"Any patient who fulfils a single criterion of the metabolic syndrome should be considered at risk for development of the metabolic syndrome and preventive strategies should be in place," they comment in Early Intervention in Psychiatry.

The findings come from a study of 46 antipsychotic-naïve schizophrenia patients, aged a mean of 31 years, attending the outpatient unit of a multi-specialty tertiary-care hospital in North India.

The metabolic syndrome was defined according to both International Diabetes Federation (IDF) criteria and modified National Cholesterol Education Program - Third Adult Treatment Panel (NCEP ATP III) criteria for Asian populations.

In total, five patients fulfilled IDF criteria for the metabolic syndrome and six patients met modified NCEP ATP III criteria for the syndrome.

However, the prevalence of individual metabolic syndrome components was much more common.

Indeed, 36.5% had increased waist circumference (≥90 cm for men, ≥80 cm for women), 36.5% had low HDL levels (<40 mg/dL in men, <50 mg dL in women), 26.1% were obese (body mass index ≥25 kg/m²), 26.1% had abnormal blood pressure (≥130/≥85 mmHg), and 24.0% had elevated triglyceride levels (≥150 mg/dL).

Grover et al conclude: "The finding of a high prevalence of subthreshold metabolic syndrome (presence of one or two criteria) suggests that clinicians should not just focus on patients who have metabolic syndrome, but also look at this large high-risk population, which can convert to metabolic syndrome."

They add that the findings "also suggest that it is important to regularly monitor all the individual metabolic syndrome criteria and also reinforce the need for careful selection of the right antipsychotic medication in patients with schizophrenia."

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