3-year incidence and predictors of metabolic syndrome in schizophrenia in the national FACE-SZ cohort
2023
Godin, O. | Pignon, B. | Szoke, A. | Boyer, L. | Aouizerate, B. | Schorr, B. | André, M. | Capdevielle, D. | Chereau, I. | Coulon, N. | Dassing, R. | Dubertret, C. | Etain, B. | Leignier, S. | Llorca, P.M. | Mallet, J. | Misdrahi, D. | Passerieux, C. | Rey, R. | Urbach, M. | Schürhoff, F. | Leboyer, M. | Fond, G. | Institut Mondor de Recherche Biomédicale (IMRB) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) | Fondation FondaMental [Créteil] | Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS) ; Aix Marseille Université (AMU) | Nutrition et Neurobiologie intégrée (NutriNeuro) ; Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS) ; Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg ; Les Hôpitaux Universitaires de Strasbourg (HUS)-Les Hôpitaux Universitaires de Strasbourg (HUS) | Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC) ; Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM) | Neuro-Psycho Pharmacologie des Systèmes Dopaminergiques sous-corticaux (NPsy-Sydo) ; CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]) | Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère] ; Centre Hospitalier Alpes Isère [Grenoble, France] (CH Alpes Isere) | Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité) | Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S 1144 / U1144)) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité) | Département de Psychiatrie et de Médecine Addictologique [AP-HP HU Saint-Louis, Lariboisière, Fernand Widal] (HUSLS-LRB-FW) ; Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal | Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA) ; Université de Bordeaux (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS) | Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay | Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL) ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) | ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010)
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Show more [+] Less [-]English. Aims: Metabolic Syndrome (MetS) is a major health epidemic of Western countries and patients with schizophrenia is a particularly vulnerable population due to lifestyle, mental illness and treatment factors. However, we lack prospective data to guide prevention. The aim of our study is then to determine MetS incidence and predictors in schizophrenia.Method: Participants were recruited in 10 expert centers at a national level and followed-up for 3 years. MetS was defined according to the International Diabetes Federation criteria. Inverse probability weighting methods were used to correct for attrition bias.Results: Among the 512 participants followed-up for 3 years, 77.9% had at least one metabolic disturbance. 27.5% were identified with MetS at baseline and excluded from the analyses. Among the rest of participants (N = 371, mean aged 31.2 (SD = 9.1) years, with mean illness duration of 10.0 (SD = 7.6) years and 273 (73.6%) men), MetS incidence was 20.8% at 3 years and raised to 23.6% in tobacco smokers, 29.4% in participants receiving antidepressant prescription at baseline and 42.0% for those with 2 disturbed metabolic disturbances at baseline. Our multivariate analyses confirmed tobacco smoking and antidepressant consumption as independent predictors of MetS onset (adjusted odds ratios (aOR) = 3.82 [1.27-11.45], p = 0.016, and aOR = 3.50 [1.26-9.70], p = 0.0158). Antidepressant prescription predicted more specifically increased lipid disturbances and paroxetine was associated with the highest risk of MetS onset.Conclusion: These results are an alarm call to prioritize MetS prevention and research in schizophrenia. We have listed interventions that should be actively promoted in clinical practice.
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