Total white blood cell count, liver enzymes, and metabolic syndrome in schizophrenia
Total white blood cell count, liver enzymes, and metabolic syndrome in schizophrenia
Background/aim: Metabolic syndrome (MetS) is an important clinical issue in patients with schizophrenia, but its associated factors are still ambiguous. The aim of the present study was to test whether there are any associations between MetS and white blood cell (WBC) levels, liver enzymes, or sociodemographic variables. Materials and methods: The study included 91 patients with a diagnosis of schizophrenia. We used the National Cholesterol Education Program s Third Adult Treatment Protocol criteria to evaluate MetS in patients. Schizophrenia patients with MetS were compared with those without MetS on the basis of demographic and clinical characteristics and total WBC counts. We conducted Spearman s correlation and binary logistic regression analyses to achieve the best prediction of MetS in schizophrenia. Results: Compared with schizophrenia patients without MetS, those with MetS were older, less educated, and more likely to be smokers. They were also more likely to have a longer duration of the illness, a longer untreated period, and higher alanine aminotransferase (ALT) and WBC levels. MetS was correlated with age, duration of illness, income, ALT, gamma-glutamyl transpeptidase, WBC, and hemoglobin values. Age and WBC levels were found to be the best predictors of MetS. Conclusion: Hemograms and liver tests should be conducted to test for MetS in schizophrenia.
___
- 1. De Hert MA, van Winkel R, Van Eyck D, Hanssens L, Wampers M, Scheen A, Peuskens J. Prevalence of the metabolic syndrome in patients with schizophrenia treated with antipsychotic medication. Schizophr Res 2006; 83: 8793.
- 2. McEvoy JP, Meyer JM, Goff DC, Nasrallah HA, Davis SM, Sullivan L, Meltzer HY, Hsiao J, Scott Stroup T, Lieberman JA. Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005; 80: 1932.
- 3. Papanastasiou E. The prevalence and mechanisms of metabolic syndrome in schizophrenia: a review. Ther Adv Psychopharmacol 2013; 3: 3351.
- 4. Nousen EK, Franco JG, Sullivan EL. Unraveling the mechanisms responsible for the comorbidity between metabolic syndrome and mental health disorders. Neuroendocrinology 2013; 98: 254266.
- 5. Milano W, De Rosa M, Milano L, Capasso A. Antipsychotic drugs opposite to metabolic risk: neurotransmitters, neurohormonal and pharmacogenetic mechanisms underlying with weight gain and metabolic syndrome. Open Neurol J 2013; 7: 2331.
- 6. Mitchell AJ, Vancampfort D, Sweers K, van Winkel R, Yu W, De Hert M. Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders--a systematic review and meta-analysis. Schizophr Bull 2013; 39: 306318.
- 7. Na KS, Kim WH, Jung HY, Ryu SG, Min KJ, Park KC, Kim YS, Yoon JS, Ahn YM, Kim CE. Relationship between inflammation and metabolic syndrome following treatment with paliperidone for schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39: 295300.
- 8. Miller BJ, Mellor A, Buckley P. Total and differential white blood cell counts, high-sensitivity C-reactive protein, and the metabolic syndrome in non-affective psychoses. Brain Behav Immun 2013; 31: 8289.
- 9. Fan X, Liu EY, Freudenreich O, Park JH, Liu D, Wang J, Yi Z, Goff D, Henderson DC. Higher white blood cell counts are associated with an increased risk for metabolic syndrome and more severe psychopathology in non-diabetic patients with schizophrenia. Schizophr Res 2010; 118: 211217.
- 10. Kim EY, Kim SH, Lee NY, Yoon JS, Kim CE, Kim YS, Ahn YM. Aminotransferase levels as a prospective predictor for the development of metabolic syndrome in patients with schizophrenia. Psychopharmacology (Berl) 2014; 231: 4479 4487.
- 11. First MB, Michael B, Spitzer RL, Robert L, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington DC, USA: American Psychiatric Press Inc.; 1996.
- 12. Çorapçıoğlu A, Aydemir Ö, Yıldız M, Esen A, Köroğlu E. DSM-IV Eksen I Bozuklukları (SCID-I) Için Yapılandırılmış Klinik Görüşme Türkçe Versiyonu. Ankara, Turkey: Hekimler Yayın Birliği; 1999 (in Turkish).
- 13. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285: 24862497.
- 14. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003-2006. Natl Health Stat Reports 2009; 13: 17.
- 15. Scuteri A, Laurent S, Cucca F, Cockcroft J, Cunha PG, Mañas LR, Raso FU, Muiesan ML, Rylikyte L, Rietzschel E et al. Metabolic syndrome across Europe: different clusters of risk factors. Eur J Prev Cardiol 2015; 22: 486491.
- 16. Onat A, Hergenç G, Can G. Prospective validation in identical Turkish cohort of two metabolic syndrome definitions for predicting cardiometabolic risk and selection of most appropriate definition. Anadolu Kardiyol Derg 2007; 7: 2934 (article in Turkish with an abstract in English).
- 17. Kozan O, Oguz A, Abaci A, Erol C, Ongen Z, Temizhan A, Çelik S. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr 2007; 61: 548553.
- 18. Gemalmaz A, Aydın S, Başak O, Disçigil G, Karul A. Prevalence of the metabolic syndrome in a rural Turkish population: comparison and concordance of two diagnostic criteria. Turk J Med Sci 2008; 38: 159165.
- 19. Sanisoglu SY, Oktenli C, Hasimi A, Yokusoglu M, Ugurlu M. Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health 2006; 6: 92.
- 20. Yazici MK, Anil Yağcioğlu AE, Ertuğrul A, Eni N, Karahan S, Karaağaoğlu E, Tokgözoğlu SL. The prevalence and clinical correlates of metabolic syndrome in patients with schizophrenia: findings from a cohort in Turkey. Eur Arch Psy Clin N 2011; 261: 6978.
- 21. Enez Darcin A, Yalcin Cavus S, Dilbaz N, Kaya H, Dogan E. Metabolic syndrome in drug-naïve and drug-free patients with schizophrenia and in their siblings. Schizophr Res 2015; 166: 201206.
- 22. Smits MM, Ioannou GN, Boyko EJ, Utzschneider KM. Nonalcoholic fatty liver disease as an independent manifestation of the metabolic syndrome: results of a US national survey in three ethnic groups. J Gastroenterol Hepatol 2013; 28: 664 670.
- 23. Ekstedt M, Franzen LE, Mathiesen UL, Thorelius L, Holmqvist M, Bodemar G, Kechagias S. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology 2006; 44: 865873.
- 24. Lee NY, Roh MS, Kim SH, Jung DC, Yu HY, Sung KH, Chung IW, Youn T, Kang UG, Ahn YM et al. The prevalence of metabolic syndrome and its association with alanine aminotransferase in clozapine-treated Korean patients with schizophrenia. Int Clin Psychopharmacol 2013; 28: 7179.