Clozapine use and sedentary lifestyle as determinants of metabolic syndrome in outpatients with
schizophrenia
Sammanfattning
Background: Schizophrenia patients are in danger of developing metabolic syndrome (MetS) and its
outcomes type 2 diabetes and cardiovascular disease. Antipsychotic treatment and adverse lifestyle
increase the burden of metabolic problems in schizophrenia, but little is known about the role of
patients’ current psychiatric problems and living arrangements in MetS. Aims: This study aims to
evaluate correlations between MetS, severity of psychiatric symptoms, living arrangements, health
behaviour and antipsychotic medication in outpatients with schizophrenia spectrum disorders.
Methods: A general practitioner and psychiatric nurses performed a comprehensive health
examination for all consenting patients with schizophrenia spectrum disorders treated in a psychosis
outpatient clinic. Examination comprised of an interview, a questionnaire, measurements, laboratory
tests and a general clinical examination. Diagnosis of MetS was made according to International
Diabetes Federation (IDF) definition. Correlations were calculated and logistic regression analysis
performed with SAS. Results: 276 patients (men n = 152, mean age± standard deviation = 44.9 ± 12.6
years) participated in the study; 58.7% (n = 162) of them had MetS according to the IDF definition.
Clozapine use doubled the risk of MetS (OR = 2.04, 95% CI 1.09-3.82, P = 0.03), whereas self-reported
regular physical activity decreased the risk significantly (OR = 0.32, 95% CI 0.18-0.57, P < 0.001). We
found no correlations between MetS and living arrangements or current severity of psychiatric
symptoms. Conclusions: MetS was alarmingly common in our sample. Even moderate physical
activity was associated with decreased risk of MetS. Promotion of a physically active lifestyle should
be one of the targets in treatment of schizophrenia, especially in patients using clozapine.