Racial and ethnic differences in the presentation of metabolic syndrome. Diabetes mellitus and hypertension have comparable adverse effects on health-related quality of life.
Overall, the costs associated with antipsychotic therapy, diagnosis and treatment of side effects, and discontinuation and switching of antipsychotic therapy were higher among patients treated with olanzapine. Other researchers have taken the view that there needs to be a much more coordinated approach between primary and secondary care.
Reaven proposed insulin resistance as the underlying factor and named the constellation of abnormalities syndrome X. Consensus development conference on antipsychotic drugs and obesity and diabetes.
Therefore, the aim of this prospective cross-sectional study is to assess the hypothesis that MetSyn is an independent determinant of HRQoL.
Due to compensatory mechanisms, early stages of HF lack specific signs; however, late stages of HF demonstrate the following signs: N Engl J Med.
It is characterized by adipose tissue accumulation predominantly around the waist and trunk.
Regression analysis was performed to identify if the presence of metabolic syndrome was an independent risk factor for each outcome. For example, Barnett and colleagues reported that patients taking atypical antipsychotic medications were more likely than those patients taking first-generation drugs to undergo glucose testing odds ratio [OR], 1.
Taking as many of the above factors into account as possible, Reynolds and Kirk assessed the relative affinities at relevant receptors for currently used antipsychotic drugs and provided substantive evidence that both olanzapine and clozapine are qualitatively more problematic than other drugs in both the severity of associated weight gain and the risk of glucose intolerance.
Does antipsychotic polypharmacy increase the risk for metabolic syndrome? Researchers investigated 4 HTR2C genetic variants in patients with schizophrenia who were mainly using clozapine, olanzapine, and risperidone, and reported that 3 of the 4 HTR2C polymorphisms were associated with an increased risk of metabolic syndrome.
Diet[ edit ] Dietary carbohydrate restriction reduces blood glucose levels, contributes to weight loss, and reduces the use of several medications that may be prescribed for metabolic syndrome.
The mean BMI of subjects in this study was overweight Adapted from Ahmad et al. It also is possible that this increase in accessibility and shift in policy regarding reimbursement could decrease the reluctance of some practitioners to both prescribe and monitor the effects of antipsychotic medications in both schizophrenia and other patient indications, but this remains to be tested.
Obesity and health-related quality of life: A well-designed study conducted in units of primary health care could provide more representative, population-based data with regard to potential associations of psychosocial and sociodemographic characteristics with morbidities, such as the MetS.
However, for international comparisons and to facilitate the etiology, it is critical that a commonly agreed-upon set of criteria be used worldwide, with agreed-upon cut points for different ethnic groups and sexes. Researchers have attempted to determine which molecular binding sites are most closely linked with specific side effects, such as weight gain, glucose dysregulation, diabetes, and dyslipidemia, across a variety of antipsychotic agents.
Also, the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference regardless of geography. New consecutive patients with a presumptive diagnosis of MetS referred to the Outpatient Lipid Clinic of the University Hospital of Ioannina the referral centre for the broader region of Epirus withinhabitantsfrom April to Januarywere involved in the study.
Many components of metabolic syndrome are associated with a sedentary lifestyle, including increased adipose tissue predominantly central ; reduced HDL cholesterol ; and a trend toward increased triglyceridesblood pressureand glucose in the genetically susceptible. The differential prevalence of metabolic syndrome associated with various atypical antipsychotic medications has been evidenced across numerous studies, with higher effects seen for certain antipsychotic medications on weight gain, waist circumference, fasting triglyceride level, and glucose levels.
The prevalence of the metabolic syndrome using the National Cholesterol Educational Program and International Diabetes Federation definitions. Diabetes mellitus and Diabetes mellitus type 2 The metabolic syndrome quintuples the risk of type 2 diabetes mellitus.
The IDF consensus worldwide definition of the metabolic syndrome. Acute effects of newer antipsychotic drugs on glucose metabolism. However, more recent evidence suggests that common triggers for example, excessive sugar-intake in the environment of overabundant food can contribute to the development of multiple metabolic abnormalities at the same time, supporting the commonality of the energy utilization and storage pathways in metabolic syndrome.
HF causes slight limitations to physical activity; the patients are comfortable at rest, but ordinary physical activity results in HF symptoms. Screening for the metabolic syndrome in patients receiving antipsychotic treatment: However, obesity without metabolic syndrome does not confer a significant cardiovascular risk, whereas metabolic syndrome without obesity is associated with a significant risk of diabetes and cardiovascular disease.
The HADS is a brief self-assessment scale assessing the two most common aspects of psychological distress found in hospital settings: Cost-effective screening for the metabolic syndrome in patients treated with second-generation antipsychotic medications.
Clinical evaluation According to the study protocol, at the first visit of each subject in the Outpatient Lipid Clinic, the following parameters were evaluated: Furthermore, although in a nursing home or long-term care facility, the percentage of deaths have been decreased from Therefore, more research is needed to better understand these factors before improvements can be made in diabetes and dyslipidemia screening for this at-risk population.
This finding implies that most patients with metabolic syndrome treated with an atypical antipsychotic could be successfully identified by model prediction using only a few easily and immediately available clinical variables eg, waist circumference, diastolic BP, BMI, and female sexcontingent on choice of predictive modeling adopted.
With appropriate cardiac rehabilitation and changes in lifestyle e. However, this potentially excludes any subject without increased waist circumference if BMI is less than Abstract. Background: Poor glycemic and blood pressure (BP) control in patients with type 2 diabetes mellitus (T2DM) may lead to higher risk of complications with varying healthcare resource utilization (HRU).
We hypothesize that poor glycemic and BP control are associated with higher HRU/costs. May 15, · To identify if metabolic syndrome is an independent risk factor for increased major perioperative complications, cost, length of stay and non-routine discharge. We obtained the National Inpatient Sample from the Hospital Cost and Utilization Project for each year between and All patients.
The objectives of this study therefore were to: (1) determine if excessive daytime sleepiness is associated with increased health care utilization, and (2) identify determinants of increased health care utilization among patients referred for assessment of OSA.
Evaluation of Healthcare Utilization in Patients with Metabolic Syndrome Abstract Metabolic Syndrome is a cluster of cardio-metabolic risk factors, including obesity, hyperglycemia, dyslipidaemia and hypertension, and has been linked with elevated risk of developing.
The pickwickian syndrome is a severe form of the obesity-hypoventilation syndrome. Named after an obese character in Charles Dickens' The Pickwick Papers, this syndrome involves extreme obesity, irregular breathing, somnolence, cyanosis, secondary polycythemia, and right ventricular dysfunction.
Nonmodifiable risk factors include increasing age, sex (with increased rates of obesity, diabetes, and metabolic syndrome in treated female patients); personal and family history of obesity, diabetes, heart disease; and ethnicity (with increased rates of diabetes, metabolic syndrome, and coronary heart disease in patients of non-European descent).Download