Comparison of metabolic parameters and Framingham cardiovascular risk scores before and after in-hospital treatment with antipsychotics

Abstract

Background. The objective of this naturalistic study was to evaluate changes in the prevalence of metabolic syndrome (MetS) and Framingham cardiovascular risk scores in adult with schizophrenia after in-hospital treatment with antipsychotics. Methods. For 58 patients (36 women and 22 men) the following data was acquired on admission and at discharge: body height and weight, waist circumference, cigarette smoking, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides (TGA), fasting plasma glucose (FPG), blood pressure, concomitant use of antidiabetic, antihypertensive and antihyperlipidemic medications. Results. Mean TGA levels increased significantly (140.32 mg/dL vs. 180.17 mg/dL), other parameters did not change. MetS prevalence on admission and at discharge did not differ significantly, irrespective of definition used (IDF: 50.00% vs. 60.34%; ATPIII: 39.66% vs. 43.10%; ATPIII A: 46.55% vs. 51.72%). Two cardiovascular risk scores were reduced at discharge: stroke, 10-year (4.10% vs. 3.46%) and hypertension, 4-year (22.18% vs. 16.58%). Other Framingham risk scores did not change. Very high prevalence of abnormal body weight (up to 65%), abdominal obesity (63% in men and 89% in women), hypertension (>50%) and lipid abnormalities (31-64%) was found. Conclusions. We have found a very high rate of MetS in patients treated with antipsychotics. No metabolic parameters improved after hospital stay, while some worsened. This did not, however, result in increased risk of cardiovascular events. Abnormal body weight and lipid abnormalities were very common in our study population. Our results indicate that metabolic parameters should be monitored regularly, particularly in outpatient settings, and appropriate treatment should be introduced as soon as any significant changes are found.