OBJECTIVES: To evaluate the
point prevalence of the
metabolic syndrome in patients with
schizoaffective disorder--bipolar type. METHODS: Consenting patients who were participants in an ongoing
clinical trial of adjunctive
topiramate treatment for
schizoaffective disorder, bipolar type were evaluated at baseline for the
point prevalence of the
metabolic syndrome. The criteria for the
metabolic syndrome included: (a)
waist circumference > 102 cm (40 inches) in males, or > 88 cm (35 inches) in females; (b) fasting serum
triglyceride levels > or = 150 mg/dL; (c) fasting
high density lipoproteins (HDL)
cholesterol <40 mg/dL in men or <50 mg/dL in women; (d)
blood pressure > or = 130/85 mmHg; and (e) fasting
glucose > or = 110 mg/dL. Subjects who had at least three of these five criteria were defined as meeting criteria for the
metabolic syndrome. RESULTS: Thirty-six subjects (males = 15, females = 21) were evaluated, and three were excluded for
missing data. Among those 33 subjects with complete data, 14 subjects (42.4%, males = 7, females = 7, African Americans = 6, Caucasians = 8) met criteria for the
metabolic syndrome. Not unexpectedly, those with the
metabolic syndrome were significantly more likely to be
obese, and have significantly higher
mean systolic and
diastolic blood pressure,
mean fasting
triglyceride levels and larger
mean waist circumferences, and significantly lower
HDL cholesterol levels; and a trend toward higher fasting
blood glucose levels. Furthermore, the fasting
mean total
cholesterol in those with the
metabolic syndrome was 217 mg/dL (+/-46). CONCLUSIONS: This preliminary report suggests that the
point prevalence of the
metabolic syndrome in patients with
schizoaffective disorder appears to be higher than that reported in the general population of the USA. Targeted weight reduction and life style change strategies (increased exercise,
smoking cessation, stress reduction) may provide useful interventions to decrease the
morbidity and mortality that accompanies the presence of the
metabolic syndrome in patients with
psychiatric illnesses.
