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

Arch Psychiatr Nurs. 2009 Jun;23(3):261-8. doi: 10.1016/j.apnu.2008.06.007. Epub 2009 Jan 15.

Abstract

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.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Antipsychotic Agents / adverse effects*
  • Clozapine / adverse effects*
  • Comorbidity
  • Cross-Sectional Studies
  • Drug Monitoring
  • Female
  • Health Services Needs and Demand
  • Humans
  • Logistic Models
  • Male
  • Mass Screening
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / etiology*
  • Multivariate Analysis
  • New South Wales / epidemiology
  • Outpatients / statistics & numerical data
  • Population Surveillance
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Schizophrenia / complications*
  • Schizophrenia / drug therapy*
  • Schizophrenia / epidemiology

Substances

  • Antipsychotic Agents
  • Clozapine