Predictive Utility of Body Mass Index for Metabolic Syndrome Among Patients with Schizophrenia in Japan

Norio Sugawara; Norio Yasui-Furukori; Manabu Yamazaki; Kazutaka Shimoda; Takao Mori; Takuro Sugai; Hiroshi Matsuda; Yutaro Suzuki; Yuji Ozeki; Kurefu Okamoto; Toyoaki Sagae; Toshiyuki Someya

doi:10.2147/NDT.S269619

Predictive Utility of Body Mass Index for Metabolic Syndrome Among Patients with Schizophrenia in Japan

Neuropsychiatr Dis Treat. 2020 Sep 30:16:2229-2236. doi: 10.2147/NDT.S269619. eCollection 2020.

Authors

Norio Sugawara^{1

2}, Norio Yasui-Furukori^{1

2}, Manabu Yamazaki³, Kazutaka Shimoda^{1

2}, Takao Mori³, Takuro Sugai^{2

4}, Hiroshi Matsuda³, Yutaro Suzuki^{2

4}, Yuji Ozeki^{2

5}, Kurefu Okamoto³, Toyoaki Sagae^{3

6}, Toshiyuki Someya^{2

4}

Affiliations

¹ Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
² Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.
³ Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan.
⁴ Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan.
⁵ Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga 520-2134, Japan.
⁶ Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Yamagata 992-0025, Japan.

Abstract

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.

Grants and funding

This work was partially supported by Eisai Co., Ltd.; Yoshitomi Pharmaceutical Industries; Dainippon Sumitomo Pharma Co., Ltd.; Astellas Pharma Inc.; Meiji Seika Pharma Co., Ltd.; Eli Lilly Japan K.K.; Otsuka Pharmaceutical Co., Ltd.; GlaxoSmithKline K.K.; Janssen Pharmaceutical K.K.; MSD K.K.; Shionogi & Co., Ltd.; Asahi Kasei Pharma Corp.; Novartis Pharma Co., Ltd.; Takeda Pharmaceutical Co., Ltd.; Ono Pharmaceutical Co., Ltd.; and Tsumura & Co. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.