Endocrine Abstracts

Introduction: Metabolic Syndrome (MetS) is a bunch of metabolic disturbances related to insulin resistance and is considered a global public health problem. The screening and management of MetS is particularly challenging in psychiatric practice.

Objectives: We aim to identify clinical and therapeutic factors associated with MetS in a Tunisian psychiatric population.

Methods: We conducted a descriptive and analytical cross-sectional study involving 126 patients who attended the psychiatry department at Gabes regional hospital, Tunisia, from 2019 to 2020. MetS was diagnosed based on the 2005-IDF criteria. We compared two subgroups:

* [MetS+]: Patients with MetS (n=32)

* [MetS−]: Patients without MetS (n=94)

Results: [MetS+] patients were significantly older ([MetS+]:52.1±10.5 versus [MetS−]:43.3±12.7 years; P=0.001). The onset of psychiatric symptoms was significantly earlier in [MetS−] ([MetS+]:36.0±14.1 versus [MetS−]:26.8±11.0 years; P=0.004). No significant gender nor addictive behaviours diffrences were reported in both subgroups. The two shared an unprivileged educational and socioeconomic backgrounds. Married patients were more affected by MetS ([MetS+]: 65.6% versus [MetS−]:43.6%; P=0.006). Schizophernia and psychotic disorders(50%), and mood disorders(18.8%) were more recorded in [MetS+] unlike anxiety disorder (18.1%) which was more prevalent in [MetS−], without any statistic significance. Mental patients are more likely to develop MetS when prescribed anxiolytics (OR=3.4; P=0.034; 95% CI[1.7–10.8]) or atypical antipsychotics (OR=9.3; P=0.001; 95% CI[2.4–36.2]).

Conclusions: Screening psychiatric patients for comorbid MetS is recommended both before and during treatment. The initial drug selection should take into consideration specific metabolic profiles. The opportune identification of MetS can facilitate early lifestyle interventions and treatment to reduce the cardiometabolic risk in this vulnerable population.