Prevalence and associated factors of metabolic syndrome in patients with schizophrenia: a multicenter cross-sectional study in China

Metabolic syndrome (MetS) is highly prevalent among individuals with schizophrenia. However, substantial regional variation exists, and evidence from large samples of hospitalized patients in China remains limited. This study aimed to estimate the prevalence of MetS and to explore its associated factors among individuals with schizophrenia in China. We included 3042 participants with schizophrenia from 25 hospitals in Zhejiang Province from April to December 2022. MetS was defined according to the Chinese Diabetes Society (CDS) criteria, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and the International Diabetes Federation (IDF) criteria. The prevalence of MetS was estimated using the Clopper-Pearson method, and generalized additive models were used to fit smoothed age-specific prevalence curves. Multivariate logistic regression was used to explore potential factors associated with MetS. The overall prevalence of MetS was 34.9% (95% confidence interval [CI]: 33.2-36.7%), 42.6% (40.9-44.4%), and 38.9% (37.2-40.7%) based on the CDS, NCEP ATP III, and IDF criteria, respectively. The prevalence of MetS was significantly higher in female participants with schizophrenia compared to their male counterparts when applying the NCEP ATP III or IDF criteria. In addition, after reaching the age-specific peak, MetS prevalence declined in male participants but stabilized in females. High BMI (OR: 1.30 [1.27-1.33]) and comorbid endocrine diseases (OR: 1.79 [1.48-2.17]) were associated with increased odds of MetS. Metabolic syndrome is highly prevalent among individuals with schizophrenia, regardless of the diagnostic criteria used. Early identification and screening of metabolic abnormalities in individuals with schizophrenia should be considered.

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Journal
Schizophrenia
Published
2025-12-01
DOI
https://doi.org/10.1038/s41537-025-00707-w
Primary Topic
Schizophrenia research and treatment
Type
article
Field-Weighted Citation Impact
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article

Prevalence and associated factors of metabolic syndrome in patients with schizophrenia: a multicenter cross-sectional study in China

Heqiu Wang, Xueming Xu, Tingting Zu, Yaguan Zhou et al.
Schizophrenia
Schizophrenia research and treatment
article

Prevalence and associated factors of metabolic syndrome in patients with schizophrenia: a multicenter cross-sectional study in China

Heqiu Wang, Xueming Xu, Tingting Zu, Yaguan Zhou, Zhilian Pi, Xiaolin Xu, Huaifeng Zhan, Wanzhen Wu, Yingying Dong, Yong Zhou, Suhong Ye, Li Ni, Ke Fu, Huan Liu, Hongfei Wang, Yanbo Chen, Liying Liu, Li Wei, Zhiyong Lan, Haihang Yu, Junjie Lin, Enyan Yu, Qian Xiao, Ming‐Hua Xie, Guidong Zhu, Wei Lv, Zhengluan Liao, Juan Huang, Xilong Jin
article en

Abstract

Metabolic syndrome (MetS) is highly prevalent among individuals with schizophrenia. However, substantial regional variation exists, and evidence from large samples of hospitalized patients in China remains limited. This study aimed to estimate the prevalence of MetS and to explore its associated factors among individuals with schizophrenia in China. We included 3042 participants with schizophrenia from 25 hospitals in Zhejiang Province from April to December 2022. MetS was defined according to the Chinese Diabetes Society (CDS) criteria, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and the International Diabetes Federation (IDF) criteria. The prevalence of MetS was estimated using the Clopper-Pearson method, and generalized additive models were used to fit smoothed age-specific prevalence curves. Multivariate logistic regression was used to explore potential factors associated with MetS. The overall prevalence of MetS was 34.9% (95% confidence interval [CI]: 33.2-36.7%), 42.6% (40.9-44.4%), and 38.9% (37.2-40.7%) based on the CDS, NCEP ATP III, and IDF criteria, respectively. The prevalence of MetS was significantly higher in female participants with schizophrenia compared to their male counterparts when applying the NCEP ATP III or IDF criteria. In addition, after reaching the age-specific peak, MetS prevalence declined in male participants but stabilized in females. High BMI (OR: 1.30 [1.27-1.33]) and comorbid endocrine diseases (OR: 1.79 [1.48-2.17]) were associated with increased odds of MetS. Metabolic syndrome is highly prevalent among individuals with schizophrenia, regardless of the diagnostic criteria used. Early identification and screening of metabolic abnormalities in individuals with schizophrenia should be considered.

SchizophreniaVol. 12(1)
The University of Queensland (AU), Wenzhou Medical University (CN), The Fourth People's Hospital (CN), Quzhou City People's Hospital (CN), Taizhou Second People's Hospital (CN), Fuyang City People's Hospital (CN), Tongde Hospital of Zhejiang Province (CN), Ningbo No. 2 Hospital (CN), Zhejiang Provincial Public Security Department (CN), Ningbo Kangning Hospital (CN), Zhejiang Hospital (CN), Third People's Hospital of Hangzhou (CN), Zhejiang Lab (CN), Zhoushan Hospital (CN), Lishui City People's Hospital (CN), Shanghai Public Security Bureau (CN), Zhejiang Provincial People's Hospital (CN), Hangzhou Seventh Peoples Hospital (CN), First Hospital of Jiaxing (CN), Third People's Hospital of Huzhou (CN), Jinzhou Kangning Hospital (CN), Xian Yang Central Hospital (CN), Wenzhou City People's Hospital (CN), Second Affiliated Hospital of Zhejiang University (CN), Shaoxing People's Hospital (CN), Jinhua Central Hospital (CN), Ningbo No.6 Hospital (CN), The Fifth People’s Hospital of Suzhou (CN), Zhejiang University (CN)
National Natural Science Foundation of China, Zhejiang University, Fundamental Research Funds for the Central Universities
Openalex Percentile: Top 56%
Schizophrenia research and treatment
DOIOpen Access PDFOpenAlex
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