Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 11-12, Pages: 712-718
https://doi.org/10.2298/SARH1512712P
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Long-term treatment with olanzapine in hospital conditions: Prevalence and predictors of the metabolic syndrome
Popović Irena (Special Hospital for Mental Disorders Gornja Toponica, Niš)
Ravanić Dragan (Faculty of Medical Sciences, Kragujevac)
Janković Slobodan (Faculty of Medical Sciences, Kragujevac)
Milovanović Dragan (Faculty of Medical Sciences, Kragujevac)
Folić Marko (Faculty of Medical Sciences, Kragujevac)
Stanojević Albina (Special Hospital for Mental Disorders Gornja Toponica, Niš)
Nenadović Milutin (Faculty of Medical Sciences, Department for Psychiatry, Kosovska Mitrovica)
Ilić Milena (Faculty of Medical Sciences, Kragujevac)
Introduction. The risk of metabolic abnormalities is greatly increased in
schizophrenic patients started on an atypical antipsychotic medication.
Patients with psychiatric disorders exceed mortality ranges resulting from,
among others, increased risk of cardiovascular events. Other factors
contributing to the development of metabolic syndrome include prolonged
duration of illness, increasing age, female sex and lifestyle factors.
Objective. This cross-sectional study was taken up to assess the prevalence
of the metabolic syndrome (MetS) in schizophrenic patients receiving
olanzapine monotherapy for at least six months and to determine the most
important risk factors associated with metabolic syndrome presence in these
patients. Methods. A total of 93 long term hospitalized schizophrenic
patients (71 men, 22 women), had a screening of the following: case-history
data, psychiatric scales, anthropometric measures, blood (fasting glucose,
lipid status, C-reactive protein - CRP) and urine samples (microalbuminuria).
Results. Prevalence of MetS according to International Diabetes Federation
criteria in our study was 34.4%. The multivariate analysis distinguished the
following significant predictors of MetS presence (in order of appearance):
data about diabetes mellitus in family history (p=0.002), body mass index >25
kg/m2 (p=0.002), hyperlipidemia in family history (p=0.008), and elevated CRP
value (p=0.042). Conclusion. High rate of MetS in patients treated with
olanzapine in this study exceeds MetS prevalence in general population. Among
observed parameters, our study pointed to several “high risk” predictors
associated with MetS presence. Regular monitoring of cardiometabolic risk
factors is highly recommended. Positive heredity distress mentioned above may
direct a psychiatrist to prescribe some other drug than olanzapine in the
long term treatment of schizophrenia.
Keywords: metabolic syndrome, schizophrenia, olanzapine