Predictive Utility of Body Mass Index for Metabolic Syndrome Among Patients with Schizophrenia in Japan
Received 27 June 2020
Accepted for publication 8 September 2020
Published 30 September 2020 Volume 2020:16 Pages 2229—2236
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Taro Kishi
Norio Sugawara,1,2 Norio Yasui-Furukori,1,2 Manabu Yamazaki,3 Kazutaka Shimoda,1,2 Takao Mori,3 Takuro Sugai,2,4 Hiroshi Matsuda,3 Yutaro Suzuki,2,4 Yuji Ozeki,2,5 Kurefu Okamoto,3 Toyoaki Sagae,3,6 Toshiyuki Someya2,4
1Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan; 2Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan; 3Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan; 4Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan; 5Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga 520-2134, Japan; 6Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Yamagata 992-0025, Japan
Correspondence: Norio Sugawara
Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan
Tel +81-28-287-2153 (extension: 7141)
Background: Reliable and easy screening for metabolic syndrome (MetS) is important for patients with schizophrenia. The aim of this study was to assess the predictive utility of body mass index (BMI) for MetS among patients with schizophrenia in Japan.
Methods: In total, 8468 patients (4705 males, 3763 females) with schizophrenia or schizoaffective disorders based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), or the International Classification of Diseases, tenth revision (ICD-10), were assessed for MetS using the criteria of the National Cholesterol Education Program Adult Treatment Panel III (ATP III-A). We applied a stratum-specific likelihood ratio (SSLR) analysis, which is independent of the prevalence of the target disease.
Results: The mean (± standard deviation) age of these patients was 57.4 ± 13.5 years. The prevalence of MetS was 20.4%. Among males, the SSLRs predicting MetS were 0.03 (95% CI 0.02– 0.06), 0.54 (95% CI 0.48– 0.60), 2.77 (95% CI 2.44– 3.14) and 8.75 (95% CI 7.40– 10.36) for BMI < 20 kg/m2, 20 kg/m2 ≤ BMI < 25 kg/m2, 25 kg/m2≤ BMI < 28 kg/m2, and 28 kg/m2≤BMI, respectively. For females, the SSLRs predicting MetS were 0.08 (95% CI 0.05– 0.12), 0.73 (95% CI 0.66– 0.82), 2.50 (95% CI 2.16– 2.90) and 4.83 (95% CI 4.12– 5.67) for the same BMI categories, respectively.
Conclusion: The predictive utility of BMI is confirmed, and BMI has more predictive value in males than in females. Patients with a BMI of 28 kg/m2 or greater had a significantly higher SSLR than those with a BMI less than 28 kg/m2.
Keywords: body mass index, metabolic syndrome, schizoaffective disorder, schizophrenia
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