Cardiometabolic risk in Turkish patients with first episode schizophrenia

Objective: Studies in first episode schizophrenia samples about status of cardiovascular risk and prevalence of metabolic syndrome have demonstrated inconsistent results. We aimed to determine the Framingham cardiovascular risk profile and prevalence of metabolic syndrome in patients with first-episode schizophrenia.

Methods: Between 04.2012 and 03.2013, our study was carried out with participants, who met clinical and DSM-IV criteria for schizophrenia, for the diagnosis of first episode schizophrenia, was conducted in Erenkoy Mental and Neurological Diseases Training and Research Hospital, 48 patients who agreed to participate in the study, and, 48 healthy people with no known psychiatric disorders as a control group, were included in the study. Cardiovascular risk was rated with the Framingham Risk Scoring (FRS) system. According to the degree of risk, patients were classified as <10%, 10-20% and >20%, respectively, in the form of low risk, medium risk and high risk groups. The presence of the metabolic syndrome was examined. To determine the level of physical activity, the International Physical Activity Questionnaire Short Form-seven days, ‘the Turkish version was used. Dietary habits were evaluated by the ‘Simplified fat screener and Simplified fiber/fruit/vegetable screener’ scales were used.

Results: Mean age was 31.4±9.6 years in patients with first-episode schizophrenia (n=48), 31.3±9.4 in the control group (n=48) (p>0.05). The average age of onset of first-episode schizophrenia was 28.9±9.2 years, mean disease duration was 2.73±3.3, treatment time was 2.6±3.4 years. Framingham risk score in the patient group was 1.60±1.3, and 1.95±3.8 in the control group. There was no significant difference. Fat-rich diet prevalence was 29.2% in patients and 50% in the control group. The difference was significant (χ²:4.356, p=0.037). Physical activity levels in patients were 35.4% with mild activity, 64.6% with moderate activity, and 0% with intense activity. In the control group, mild activity prevalence was 62.5% while moderate activity was 2.1% and intensive activity was 35.4%. The difference was statistically significant (χ²:8.679, p=0.013). Prevalence of metabolic syndrome; according to ATP-III, was 2.1% in patients group and 8.3% in the control group. There was no significant difference between groups in terms of ATP-IIIa. ATP-IIIa was 8.3% in patient group and 10.4% in control group.

Conclusion: These findings suggest that in patients with first-episode schizophrenia, the prevalence rate of metabolic syndrome and ratio of cardiovascular risk appeared to be no higher than that of the healthy population.