This study assessed the prevalence of MS in patients treated with antipsychotics using two proposed NCEP-ATP-III definitions.

A retrospective, cross-sectional, multicenter study was carried out by 117 Spanish Psychiatrists (The CLAMORS Collaborative Group). Consecutive outpatients meeting DSM-IV criteria for Schizophrenia, Schizophreniform or Schizoaffective Disorder, under antipsychotic treatment for at least 12 weeks, were recruited. MS was defined as fulfilment of at least 3 of the following components: waist circumference >102(men) / >88(women)cm (NCEP-ATP-III definition), or BMI>=28.8 kg/m2, (revised NCEP-ATP-III definition); tryglicerides>=150mg/dL; HDL-cholesterol <40mg/dL(men) / <50mg/dL(women); blood pressure >=130/85; fasting glucose >=110mg/dL. Kappa coefficients and bivariate logistic regression models were applied.

1452 evaluable patients (863 men, 60.9%), 40.7+12.2 years (mean+SD) were included. MS was presented in 24.6% [23.6%(men), 27.2%(women); p=0.130)] (NCEP-ATP-III definition), and in 25.5% [25.6%(men), 25.6%(women); p=0.9924)] (revised NCEP-ATP-III definition). Kappa coefficient between both definitions was 0.81 [0.81(men), 0.84(women)]. Obesity component was present in 42.4% of patients [34.3%(men), 54.5%(women); p<0.001] when defined by waist circumference (NCEP-ATP-III definition), and in 38.2% [36.7%(men), 39.4%(women); p=0.3156] when defined by BMI (revised NCEP-ATP III definition). Obesity component was less associated to presence of MS when it was defined by waist circumference (OR=9.99, 95%CI:7.37-13.55), than when it was defined by BMI (OR=11.19, 95%CI:8.42-14.87).

Obesity plays a central role in the NCEP-ATP-III definition of MS. Prevalence of the abdominal obesity component may be assessed by either the measurement of the waist circumference or by calculation of the body mass index without losing reliability.

On behalf of the CLAMORS Collaborative Group.