Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 13 06 2020
accepted: 22 12 2020
entrez: 11 1 2021
pubmed: 12 1 2021
medline: 11 5 2021
Statut: epublish

Résumé

A high prevalence of metabolic syndrome and its components in patients with psychotic disorders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work in this field has emerged from low-resourced contexts. This study investigated the prevalence, correlates, and treatment patterns of metabolic disorders in patients with psychotic disorders in Western Kenya. 300 patients with psychosis and 300 controls were recruited at Moi Teaching and Referral Hospital in Eldoret, Kenya. Data on demographic characteristics, weight, height, abdominal circumference, blood pressure, blood glucose, lipid profile, and treatments were collected. Categorical and continuous data were compared between the patient and control groups using Pearson's chi-squared tests and t-tests, respectively. Variables found to be significantly different between these groups were included in logistic regression models to determine potential predictors of metabolic syndrome. Compared to controls, patients with psychosis were found to have a higher mean random blood glucose [5.23 vs 4.79, p = 0.003], higher body mass index [5.23 vs 4.79, p = 0.001], higher triglycerides [1.98 vs 1.56, p<0.001], larger waist circumference [89.23 vs 86.39, p = 0.009] and lower high density lipoprotein [1.22 vs 1.32, p<0.001]. The odds of developing metabolic syndrome were increased with age [OR = 1.05, CI: 1.02-1.07] and presence of a psychotic disorder [OR = 2.09 [CI 1.23-3.55]; and were reduced with female gender [OR 0.41, CI 0.25-0.67], among those who were never married [OR 0.52, CI 0.28-0.94] and among the widowed/separated/ divorced marital status [OR 0.38, CI 0.17-0.81]. While the majority of patients received treatment with olanzapine, there was no association between olanzapine use and metabolic syndrome and its components. More than half of the patients in this study sample were not receiving treatment for the various components of metabolic syndrome. In the study setting of Eldoret, metabolic syndrome and its components were more prevalent among patients with psychotic disorders than in controls; and a clear treatment gap for these disorders was evident. There is a need for efforts to ensure adequate screening and treatment for these physical disorders in resource-limited settings.

Sections du résumé

BACKGROUND
A high prevalence of metabolic syndrome and its components in patients with psychotic disorders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work in this field has emerged from low-resourced contexts. This study investigated the prevalence, correlates, and treatment patterns of metabolic disorders in patients with psychotic disorders in Western Kenya.
METHODS
300 patients with psychosis and 300 controls were recruited at Moi Teaching and Referral Hospital in Eldoret, Kenya. Data on demographic characteristics, weight, height, abdominal circumference, blood pressure, blood glucose, lipid profile, and treatments were collected. Categorical and continuous data were compared between the patient and control groups using Pearson's chi-squared tests and t-tests, respectively. Variables found to be significantly different between these groups were included in logistic regression models to determine potential predictors of metabolic syndrome.
RESULTS
Compared to controls, patients with psychosis were found to have a higher mean random blood glucose [5.23 vs 4.79, p = 0.003], higher body mass index [5.23 vs 4.79, p = 0.001], higher triglycerides [1.98 vs 1.56, p<0.001], larger waist circumference [89.23 vs 86.39, p = 0.009] and lower high density lipoprotein [1.22 vs 1.32, p<0.001]. The odds of developing metabolic syndrome were increased with age [OR = 1.05, CI: 1.02-1.07] and presence of a psychotic disorder [OR = 2.09 [CI 1.23-3.55]; and were reduced with female gender [OR 0.41, CI 0.25-0.67], among those who were never married [OR 0.52, CI 0.28-0.94] and among the widowed/separated/ divorced marital status [OR 0.38, CI 0.17-0.81]. While the majority of patients received treatment with olanzapine, there was no association between olanzapine use and metabolic syndrome and its components. More than half of the patients in this study sample were not receiving treatment for the various components of metabolic syndrome.
CONCLUSION
In the study setting of Eldoret, metabolic syndrome and its components were more prevalent among patients with psychotic disorders than in controls; and a clear treatment gap for these disorders was evident. There is a need for efforts to ensure adequate screening and treatment for these physical disorders in resource-limited settings.

Identifiants

pubmed: 33428652
doi: 10.1371/journal.pone.0245086
pii: PONE-D-20-18075
pmc: PMC7799838
doi:

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0245086

Déclaration de conflit d'intérêts

The authors declare no conflicting interest.

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Auteurs

Edith Kwobah (E)

Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya.

Nastassja Koen (N)

Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
South African Medical Research Council [SAMRC], Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa.
Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

Ann Mwangi (A)

Department of Behavioral Sciences, Moi University School of Medicine, Eldoret, Kenya.

Lukoye Atwoli (L)

Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya.

Dan J Stein (DJ)

Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
South African Medical Research Council [SAMRC], Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa.
Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

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