Objective We designed a nationwide study with limited exclusion criteria to investigate the prevalence of metabolic syndrome (MetS) in Korea and its relationship with antipsychotic medications. in the major monotherapy group was as follows: 18.8% for quetiapine, 22.0% for aripiprazole, 33.3% for both amisulpride and paliperidone, 34.0% for olanzapine, 35% for risperidone, 39.4% for haloperidol, and 44.7% for clozapine. Conclusion The prevalence of MetS is very high in patients with schizophrenia or schizoaffective disorder. Screening and monitoring of MetS is also strongly recommended. PSI-7977 class=”kwd-title”>Keywords: Metabolic syndrome, Antipsychotics, Korean population, Schizophrenia, Schizoaffective disorder INTRODUCTION Patients with schizophrenia have a reduced life expectancy for several reasons, including increased incidence of accidents, cardiovascular disease (CVD), and infectious disease.1 In particular, CVD is one of the most important causes of mortality and is responsible for about 45% of the excess mortality of schizophrenia.2 Patients with schizophrenia show 2?3 times higher risk of CVD than healthy controls.1 Many factors, including poor diet, tobacco smoking, weight gain, and low physical exercise, affect CVD development in patients with schizophrenia.3,4,5 Recently, several medications, especially antipsychotics, have been identified as having a negative impact on the development of CVD.6,7 Several comprehensive reviews concluded that atypical antipsychotics significantly increased the risk of certain CVDs, such as diabetes, compared with typical antipsychotics.6,8 Some studies also reported a higher prevalence of diabetes and hypertension in patients with schizophrenia than healthy controls.3,9,10 This increased prevalence of CVD, diabetes, and hypertension and increased mortality may be partially due to Metabolic Syndrome (MetS). MetS includes five major components: 1) abdominal obesity; 2) hypertension; 3) increased fasting glucose level; 4) hypertriglyceridemia; and 5) decreased high-density lipoprotein (HDL). The prevalence of MetS in patients with schizophrenia is usually 2?4 times higher than in healthy individuals.8,11,12,13 The prevalence of MetS in patients with schizophrenia varies across studies: 35.4% in the Netherlands,14 32.3% in Belgium,15 40.9% in the United States CATIE study,12 22.8% in Thailand,16 27.5% in Japan,17 and 31.7% in Korea.13 The causes of this variety in the prevalence include the use of different definitions of MetS, such as that of the Adult Treatment Panel III report (ATP III) of the National Cholesterol Education Program,12,14 the modified ATP III,13,15,17 and the International Diabetes Federation (IDF).16 In addition, some studies of Asian patients used Asian or Korean criteria for abdominal obesity. PSI-7977 MetS is also partially dependent on the location, lifestyle, and demographic characteristics of the patients, such as age, gender, and ethnicity.18,19,20 Patients in previous studies had very different demographic and clinical factors, such as mean age, male:female ratio, PSI-7977 duration of illness, and prescribed antipsychotic medications. Finally, some studies investigated the prevalence of MetS in a limited number of patients or patients enrolled for other purposes and not for the actual study of this prevalence. Thus, there may have been a selection bias and the results from a limited number of patients or hospitals might not be generalizable. To overcome these limitations, we designed a nationwide study with minimal exclusion criteria and from multiple psychiatric units across the nation to investigate the prevalence of MetS in Korea and the relationship between psychiatric medication and MetS prevalence. METHODS This study was a multicenter, cross-sectional, and observational study of patients diagnosed with schizophrenia or schizoaffective disorder according to Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR) diagnostic criteria. Sixteen hospitals?3 mental hospitals and 13 university-affiliated general hospitals?enrolled patients aged 18 to 65 years that had been prescribed any antipsychotic medication for the treatment Mouse Monoclonal to V5 tag. of schizophrenia or schizoaffective disorder between August 2011 and August 2013. Of the 892 patients who consented to participate in the study, we excluded PSI-7977 47 due to a lack of information, such as age, gender, blood pressure (BP), waist circumference, or blood laboratory results. Written informed consent was obtained from all patients and this study was approved by the Institutional Review Board of each hospital. Patient demographic data and histories were obtained from their medical records and by interview. We asked the patients if they had any conditions such as diabetes, dyslipidemia, or hypertension, or were overweight when they enrolled in this study. Based on the patients’ reports, we divided these subjects into patients with no medical disease and patients with medical disease. Waist circumference was measured at the umbilical level in a standing position and BP was measured using standard mercury sphygmomanometers or clinically approved automatic BP devices after a 5-minute rest. Plasma HDL cholesterol, triglycerides, and fasting blood glucose were also measured after at least 8-hour fast. MetS was diagnosed with the definitions of the modified ATP III for Korea (three or more of the following five criteria):21 waist circumference 85 cm in women or 90.