Association Of Metabolic Syndrome Distribution,Traditional Chinese Medicine Syndrome Differentiation And Related Risk Factors In Psychiatric Inpatients

BackgroundMetabolic syndrome(MS)refers to a variety of cardiovascular diseases(CVD),is a type of clinical syndrome induced by coexisting of multiple risk factors,such as obesity and dyslipidemia.The genetic and environmental factors are of crucial importance,but the key effect of insulin resistance on MS is an important cause of glucose metabolism disorder which has been confirmed].MS could trigger CVD,doing serious harm to human life and health.The incidence of MS in patients with mental disorder(MD)is 2-4 times of that in normal population.As MS high-risk population,the schizophrenic patients have not been paid enough attention,and there is no effective intervention on MS induced by antipsychotic drug.Thus,the detection and prevention of MS in schizophrenic patients has become the key.ObjectivesWith the analysis of correlation between incidence of MS in schizophrenic patients and risk factors,and the TCM syndrome differentiation,the association of MS-MD and various effect factors were investigated in order to provide a reference for its prevention,diagnosis and intervention,especially for the low-risk and high risk population.MethodsMeasured by national body mass index(BMI),1303 patients admitted to Henan Mental Hospital from May 1st,2016 to May 7th,2016 were recruited.The clinical data,such as waistline,blood pressure,body weight,and blood glucose,triglyceride,high density lipoprotein and other biochemical indicators were collected,and on-site investigation and analysis were conducted.The prevalence of MS and the TCMsyndrome differentiation distribution in patients with mental disorders,such as schizophrenia,depression,anxiety,bipolar disorder were analyzed.The age,sex,occupation,medication status,hospitalization time and biochemical indexes of 760 schizophrenic patients were summarized and analyzed to investigate the possible risk factors of schizophrenic patients with metabolic syndrome.Results1.241 out of 1303(18.5%)patients with mental disorders met the the Clinical Diagnosis Criteria of MS,163 out of 760(21.4%)schizophrenic patients met the MS criteria.120 patients(73.6%)were exuberance of phlegm-dampness type;29 out of118 depressive patients had MS,18(62.0%)were exuberance of phlegm-dampness type;5 out of 26(19.2%)patients with anxiety disorder had MS and 3 of them were exuberance of phlegm-dampness type;20 out of 102(19.6%)patients with bipolar disorder had MS and 14(70%)were exuberance of phlegm-dampness type;24 out of297(8.0%)patients with other mental disorders(obsessive-compulsive disorder,alcohol dependence,etc.)had MS and 19(79.1%)were exuberance of phlegm-dampness type.2.Out of 760,163(21.4%)schizophrenic inpatients had MS,according to TCM syndrome differentiation,32(19.6%)were stomach heat spleen stagnation,120(73.6%)were exuberance of phlegm-dampness,9(5.52%)were spleen deficiency stagnation,2(1.22%)were spleen-kidney-yang deficiency;133(17.5)patients with high risk had MS,according to TCM syndrome differentiation,18(13.5%)were stomach heat spleen stagnation;108(81.2%)were exuberance of phlegm-dampness,6(4.51%)were spleen deficiency stagnation;1(0.75%)was spleen-kidney-yang deficiency;67(8.8%)patients with low risk had MS,according to TCM syndrome differentiation,16(23.9%)were stomach heat spleen stagnation;45(67.1%)were exuberance of phlegm-dampness,6(8.96%)were spleen deficiency stagnation;no patient(0)was spleen-kidney-yang deficiency.In MS-MD,the exuberance of phlegm-dampness ranked the top,followed by stomach heat spleen stagnation,spleen deficiency stagnation,and spleen-kidney-yang deficiency.3.There were significant differences in age among MS-MD patients,high-risk population and low-risk population(P<0.01);and there was significant difference in age(X2=19.486,P=0.001),but gender,duration of illness,type of medication andTCM differentiation were not significantly different(P(29)0.05)4.Multivariate regression analysis showed that age and TCM differentiation were the independent risk factors for MS-MD.Conclusions1.The patients in different groups who met the MS criteria were 21.44% in schizophrenia,24.75% in depression,19.23% in anxiety disorder,19.60% in bipolar disorder and 8.08% in other mental disorders,respectively.241 out of 1303(18.5%)inpatients with mental disorders met the the clinical diagnosis criteria of MS.2.The MS-MD patients with exuberance of phlegm-dampness were the most commonly observed,followed by stomach heat spleen stagnation.3.163 out of 760(21.4%)schizophrenic inpatients had MS,133(17.5%)patients were at high risk and 67(8.81%)patients were at lower risk.4.Correlation analysis was conducted among the MS-MD patients,patients with high risk and patients with lower risk.Significant differences were observed in gender(P<0.01).5.Used the risk factor of MS in MD patients as the dependent variable,age,course of disease and TCM syndrome differentiation as the independent variable,the statistical analysis results showed that only the age and TCM syndrome differentiation played an important role in the occurrence of MS in schizophrenic patients.