Metabolic Syndrome Among Inpatients With Schizophrenia: Prevalence and Clinical Correlates

Background: Metabolic syndrome (MetS) is a major physical comorbidity in schizophrenia and is associated with increased risks of cardiovascular disease, diabetes, and poor prognosis. This study investigated the prevalence of MetS and its clinical correlates among Chinese inpatients with schizophrenia, with particular attention to the metabolic-risk profiles of antipsychotic regimens. Methods: This multicenter cross-sectional study included 1024 inpatients with schizophrenia from two tertiary psychiatric hospitals in Central China. MetS was diagnosed according to the criteria of the Chinese Diabetes Society. Sociodemographic, clinical, medication, physical examination, and laboratory data were collected. Antipsychotic regimens were classified as non-high-risk, high-risk, or high-risk-plus-low-risk combinations. Multivariable logistic regression was used to identify factors independently associated with MetS. Results: Overall, 398 of 1024 patients met the criteria for MetS, yielding a prevalence of 38.9% (95% confidence interval (CI), 35.9%–41.9%). Compared with patients without MetS, those with MetS were more likely to be male, older, have a higher body mass index, have a longer illness duration, exhibit depressive symptoms, report a history of smoking and alcohol use, and have greater illness severity. In the multivariable analysis, male sex (adjusted odds ratio [aOR] = 1.65, 95% CI, 1.21–2.25), older age (aOR = 1.02, 95% CI, 1.00–1.03), illness duration >5 years (aOR = 1.55, 95% CI, 1.14–2.13), Calgary Depression Scale for Schizophrenia (CDSS)-defined depressive symptoms (aOR = 2.71, 95% CI, 1.87–3.92), and high-risk antipsychotic regimens (aOR = 1.54, 95% CI, 1.15–2.06) were independently associated with MetS. High-risk-plus-low-risk combination regimens and chlorpromazine-equivalent (CPZ-eq) dose were not significantly associated with MetS. Conclusions: MetS is highly prevalent in this sample of Chinese inpatients with schizophrenia. The findings highlight the associations of both patient-level characteristics and antipsychotic regimen composition with MetS, whereas the current CPZ-equivalent dose showed no significant association. Enhanced metabolic monitoring and individualized treatment strategies are warranted in inpatient schizophrenia care.