Schizophrenia patients at higher risk of diabetes, hypertension and hyperlipidemia

A population-based study

Chun Hui Liao, Chen Shu Chang, Wan Ching Wei, Shih Ni Chang, Chien Chang Liao, Hsien Yuan Lane, Fung Chang Sung

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objective: This study investigates risks of developing diabetes mellitus (DM), hypertension, and hyperlipidemia in treating schizophrenia with first- and second-generation antipsychotics (FGA and SGA, respectively). Methods: We established two study sets, each consisting of patients with schizophrenia and without schizophrenia, from the insurance claims from 1997 to 2000. Study set I had 1631 patients taking FGA and 6524 non-schizophrenia controls; the other had 1224 patients taking SGA and 4896 controls. Controls were selected frequency matched with sex, age and the index year. All subjects were free of the studied metabolic disorders at the baseline. We measured incidences of these disorders developed by the end of 2008 in each cohort and their respective hazard ratios (HRs) for these disorders. Results: Schizophrenic patients taking FGA were older than those taking SGA. In the Cox models, significance adjusted HRs associated with SGA were 1.82 (95% confidence interval (CI) 1.30-2.55) for DM and 1.41 (95% CI 1.09-1.83) for hyperlipidemia. For those on the FGA, the risk was only significant in developing DM (HR 1.32, 95% CI 1.01-1.75). The age-specific antipsychotics-associated risks for metabolic disorders were higher in young patients than in older patients particularly for hypertension; the HRs in 10-19. years of age were 4.52 (95% CI 1.76-11.6) associated with FGA and 3.92 (95% CI 1.83-8.39) associated with SGA. Conclusions: Patients with schizophrenia on SGA have higher risk of developing metabolic disorders than those on FGA. It is likely that older patients have already gone through the age of developing these side-effects and were free of them at the baseline.

Original languageEnglish
Pages (from-to)110-116
Number of pages7
JournalSchizophrenia Research
Volume126
Issue number1-3
DOIs
Publication statusPublished - Mar 2011
Externally publishedYes

Fingerprint

Hyperlipidemias
Schizophrenia
Hypertension
Population
Confidence Intervals
Diabetes Mellitus
Antipsychotic Agents
Insurance
Proportional Hazards Models
Incidence

Keywords

  • Antipsychotics
  • Metabolic abnormality
  • Retrospective cohort study
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Schizophrenia patients at higher risk of diabetes, hypertension and hyperlipidemia : A population-based study. / Liao, Chun Hui; Chang, Chen Shu; Wei, Wan Ching; Chang, Shih Ni; Liao, Chien Chang; Lane, Hsien Yuan; Sung, Fung Chang.

In: Schizophrenia Research, Vol. 126, No. 1-3, 03.2011, p. 110-116.

Research output: Contribution to journalArticle

Liao, Chun Hui ; Chang, Chen Shu ; Wei, Wan Ching ; Chang, Shih Ni ; Liao, Chien Chang ; Lane, Hsien Yuan ; Sung, Fung Chang. / Schizophrenia patients at higher risk of diabetes, hypertension and hyperlipidemia : A population-based study. In: Schizophrenia Research. 2011 ; Vol. 126, No. 1-3. pp. 110-116.
@article{62e7e5bdafeb4c9c8e9a766bafd70d63,
title = "Schizophrenia patients at higher risk of diabetes, hypertension and hyperlipidemia: A population-based study",
abstract = "Objective: This study investigates risks of developing diabetes mellitus (DM), hypertension, and hyperlipidemia in treating schizophrenia with first- and second-generation antipsychotics (FGA and SGA, respectively). Methods: We established two study sets, each consisting of patients with schizophrenia and without schizophrenia, from the insurance claims from 1997 to 2000. Study set I had 1631 patients taking FGA and 6524 non-schizophrenia controls; the other had 1224 patients taking SGA and 4896 controls. Controls were selected frequency matched with sex, age and the index year. All subjects were free of the studied metabolic disorders at the baseline. We measured incidences of these disorders developed by the end of 2008 in each cohort and their respective hazard ratios (HRs) for these disorders. Results: Schizophrenic patients taking FGA were older than those taking SGA. In the Cox models, significance adjusted HRs associated with SGA were 1.82 (95{\%} confidence interval (CI) 1.30-2.55) for DM and 1.41 (95{\%} CI 1.09-1.83) for hyperlipidemia. For those on the FGA, the risk was only significant in developing DM (HR 1.32, 95{\%} CI 1.01-1.75). The age-specific antipsychotics-associated risks for metabolic disorders were higher in young patients than in older patients particularly for hypertension; the HRs in 10-19. years of age were 4.52 (95{\%} CI 1.76-11.6) associated with FGA and 3.92 (95{\%} CI 1.83-8.39) associated with SGA. Conclusions: Patients with schizophrenia on SGA have higher risk of developing metabolic disorders than those on FGA. It is likely that older patients have already gone through the age of developing these side-effects and were free of them at the baseline.",
keywords = "Antipsychotics, Metabolic abnormality, Retrospective cohort study, Schizophrenia",
author = "Liao, {Chun Hui} and Chang, {Chen Shu} and Wei, {Wan Ching} and Chang, {Shih Ni} and Liao, {Chien Chang} and Lane, {Hsien Yuan} and Sung, {Fung Chang}",
year = "2011",
month = "3",
doi = "10.1016/j.schres.2010.12.007",
language = "English",
volume = "126",
pages = "110--116",
journal = "Schizophrenia Research",
issn = "0920-9964",
publisher = "Elsevier",
number = "1-3",

}

TY - JOUR

T1 - Schizophrenia patients at higher risk of diabetes, hypertension and hyperlipidemia

T2 - A population-based study

AU - Liao, Chun Hui

AU - Chang, Chen Shu

AU - Wei, Wan Ching

AU - Chang, Shih Ni

AU - Liao, Chien Chang

AU - Lane, Hsien Yuan

AU - Sung, Fung Chang

PY - 2011/3

Y1 - 2011/3

N2 - Objective: This study investigates risks of developing diabetes mellitus (DM), hypertension, and hyperlipidemia in treating schizophrenia with first- and second-generation antipsychotics (FGA and SGA, respectively). Methods: We established two study sets, each consisting of patients with schizophrenia and without schizophrenia, from the insurance claims from 1997 to 2000. Study set I had 1631 patients taking FGA and 6524 non-schizophrenia controls; the other had 1224 patients taking SGA and 4896 controls. Controls were selected frequency matched with sex, age and the index year. All subjects were free of the studied metabolic disorders at the baseline. We measured incidences of these disorders developed by the end of 2008 in each cohort and their respective hazard ratios (HRs) for these disorders. Results: Schizophrenic patients taking FGA were older than those taking SGA. In the Cox models, significance adjusted HRs associated with SGA were 1.82 (95% confidence interval (CI) 1.30-2.55) for DM and 1.41 (95% CI 1.09-1.83) for hyperlipidemia. For those on the FGA, the risk was only significant in developing DM (HR 1.32, 95% CI 1.01-1.75). The age-specific antipsychotics-associated risks for metabolic disorders were higher in young patients than in older patients particularly for hypertension; the HRs in 10-19. years of age were 4.52 (95% CI 1.76-11.6) associated with FGA and 3.92 (95% CI 1.83-8.39) associated with SGA. Conclusions: Patients with schizophrenia on SGA have higher risk of developing metabolic disorders than those on FGA. It is likely that older patients have already gone through the age of developing these side-effects and were free of them at the baseline.

AB - Objective: This study investigates risks of developing diabetes mellitus (DM), hypertension, and hyperlipidemia in treating schizophrenia with first- and second-generation antipsychotics (FGA and SGA, respectively). Methods: We established two study sets, each consisting of patients with schizophrenia and without schizophrenia, from the insurance claims from 1997 to 2000. Study set I had 1631 patients taking FGA and 6524 non-schizophrenia controls; the other had 1224 patients taking SGA and 4896 controls. Controls were selected frequency matched with sex, age and the index year. All subjects were free of the studied metabolic disorders at the baseline. We measured incidences of these disorders developed by the end of 2008 in each cohort and their respective hazard ratios (HRs) for these disorders. Results: Schizophrenic patients taking FGA were older than those taking SGA. In the Cox models, significance adjusted HRs associated with SGA were 1.82 (95% confidence interval (CI) 1.30-2.55) for DM and 1.41 (95% CI 1.09-1.83) for hyperlipidemia. For those on the FGA, the risk was only significant in developing DM (HR 1.32, 95% CI 1.01-1.75). The age-specific antipsychotics-associated risks for metabolic disorders were higher in young patients than in older patients particularly for hypertension; the HRs in 10-19. years of age were 4.52 (95% CI 1.76-11.6) associated with FGA and 3.92 (95% CI 1.83-8.39) associated with SGA. Conclusions: Patients with schizophrenia on SGA have higher risk of developing metabolic disorders than those on FGA. It is likely that older patients have already gone through the age of developing these side-effects and were free of them at the baseline.

KW - Antipsychotics

KW - Metabolic abnormality

KW - Retrospective cohort study

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=79952039606&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952039606&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2010.12.007

DO - 10.1016/j.schres.2010.12.007

M3 - Article

VL - 126

SP - 110

EP - 116

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

IS - 1-3

ER -