Klinik Psikiyatri Dergisi; 2012;15(2):80-91
Şizofreni ve Şizoaffektif Bozuklukta Metabolik Sendrom
E Songur, EH Karslıoğlu, H Soygür, SU Kaymak, E Özalp, EŞ Cankurtaran
Tosya Devlet Hast., Kastamonu
Amaç: Þizofrenide mortalitenin %60'ý baþta kardiyovasküler
olmak üzere fiziksel hastalýklar nedeniyledir.
Metabolik Sendrom (MetS) kardiyovasküler mortalite
riskinin bir yordayýcýsýdýr. Bu çalýþmanýn amacý bir eðitim
hastanesinde izlenen þizofreni ve þizoaffektif bozukluk
hastalarýnda MetS sýklýðý ve eþlik eden durumlar ile iliþkisinin
saptanmasýdýr. Yöntem: Çalýþmaya 87 hasta dahil
edilmiþtir. Sosyodemografik veri formu doldurulmuþ,
"DSM-IV Eksen I Bozukluklarý Ýçin Yapýlandýrýlmýþ Klinik
Görüþme" (SCID-I) ve "Pozitif ve Negatif Semptom Ölçeði"
(PANSS) uygulanmýþtýr. Açlýk glukoz, trigliserit ve HDL
düzeyleri, vücut aðýrlýðý, boy, bel çevresi ve arteriyel kan
basýncý ölçülmüþtür. MetS tanýsý "Üçüncü Eriþkin Tedavi
Paneli" (ATP III), ATP III-A ve Uluslararasý Diyabet
Federasyonu (IDF) taný ölçütlerine göre deðerlendirilmiþtir.
Bulgular: Metabolik Sendrom sýklýðý sýrasýyla
ATP III, ATP III-A ve IDF ölçütlerine göre %42.5, %46 ve
%47.1 olarak bulunmuþtur. MetS sýklýðý kadýnlarda erkeklerden
daha fazla bulunmuþtur. MetS tanýsý konulan
hastalarýn yaþ ortalamasý da daha yüksektir. Sonuç:
Þizofreni hastalarýnda MetS sýklýðý normal topluma göre
görece daha yüksek bulunmuþtur. Özellikle ileri yaþ,
kadýn cinsiyeti, yüksek "Vücut Kitle Ýndeksi"ne (BMI) sahip
olanlarda metabolik durum gözden geçirilmelidir. Bel
çevresi, BMI, HDL ve TG düzeyleri olasý MetS'in en önemli
yordayýcýlarýdýr.
Metabolic Syndrome in Schizophrenia and Schizoaffective Disorder
Objectives: Sixty percent of mortality in schizophrenia
comes from the medical conditions, most of which are
cardiovascular diseases. Metabolic Syndrome (MetS) is a
powerful predictor for cardiovascular mortality. The aim
of this study was to examine the prevalence of MetS in
schizophrenia and schizoaffective disorder patients who
have been followed at a training hospital and its relationship
to other comorbid conditions. Method: Eighty
seven patients were included in the study. All patients
have been assessed by filling out a sociodemographic
data form, SCID-I and PANSS. Fasting blood glucose,
trigliserid and HDL levels have been evaluated. Body
weight, height, waist circumference and arterial blood
preasure have been recorded for all patients. MetS diagnosis
has been assessed according to ATP III, ATP III-A,
and IDF. Results: The prevalence of MetS was 42.5%,
46% and 47.1% according to ATP III, ATP III-A, and IDF
criteria, respectively. The prevalence of MetS was found
higher in women than in men. The mean age of patients
having MetS was also higher. Conclusion: The prevalence
of MetS in patients with schizophrenia was found
relatively higher compared to general population.
Metabolic status of patients should be examined especially
in the presence of older age, woman gender, and
higher BMI. Increased waist circumference, HDL and TG
levels, and BMI are the most important predictors of
MetS.