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Síndrome metabólico en pacientes ambulatorios con tratamiento antipsicótico en la práctica clínica habitual: evaluación transversal de una base de datos de atención primaria

Published online by Cambridge University Press:  12 May 2020

Antoni Sicras-Mainar ,
Milagrosa Blanca-Tamayo ,
Javier Rejas-Gutiérrez  and
Ruth Navarro-Artieda
Antoni Sicras-Mainar
Affiliation:
Junta Directiva de Planificación, Servicios Asistenciales Badalona SA, Gaietá Soler, Entresuelo 8, 08911Badalona (Barcelona), España
Milagrosa Blanca-Tamayo
Affiliation:
Departamento de Psiquiatría, Servicios Asistenciales de Badalona, Badalona (Barcelona), España
Javier Rejas-Gutiérrez
Affiliation:
Departmento de Investigación de Variables Médicas, Unidad Médica, Pfizer España, Alcobendas (Madrid), España
Ruth Navarro-Artieda
Affiliation:
Servicio de Documentación Médica, Hospital Germans Trías i Pujol, Badalona (Barcelona), España
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Resumen

Objetivo.

Determinar la prevalencia del síndrome metabólico (SM) en pacientes ambulatorios tratados con antipsicóticos incluidos en una base de datos de atención primaria.

Métodos.

Se realizó un estudio transversal mediante evaluación de una base de datos administrativa de reclamaciones de pacientes ambulatorios de 5 centros de atención primaria. Se incluyeron los pacientes tratados con antipsicóticos durante más de 3 meses. El grupo de control se compuso de pacientes ambulatorios incluidos en la base de datos sin exposición a ningún antipsicótico. El SM se definió según los criterios modificados del NCEP-ATP III y para su confirmación se exigieron, al menos, 3 de los 5 componentes siguientes: índice de masa corporal > 28,8 kg/m2, triglicéridos > 150 mg/ml, colesterol-HDL < 40 mg/ml (hombres) y < 50 mg/ml (mujeres), presión arterial > 130/85 mm Hg y glucosa sérica en ayunas > 110 mg/dl.

Resultados.

Identificamos a 742 pacientes [mujeres 51,5%, edad 55,1 (20,7) años] tratados con antipsicóticos de primera o segunda generación durante 27,6 (20,3) meses. Los controles fueron 85.286 pacientes ambulatorios [mujeres 50,5%, edad 45,5 (17,7) años]. La prevalencia de SM fue significativamente mayor en los sujetos tratados con antipsicóticos: 27% (IC 95%, 23,8-30,1) frente a 14,4% (14,1- 14,6%); CP ajustado a edad y sexo=l,38 (1,16-1,65, P < 0,001). Todos los componentes del SM, excepto la hipertensión, fueron significativamente más frecuentes en el grupo tratado con antipsicóticos, en particular, el índice de masa corporal > 28,8 kg/m2: 33% (29,6- 36,4%) frente al 17,8% (17,6-18,1%), CP ajustado=l,63 (1,39-1,92, P < 0,001), y niveles bajos de colesterol-HDL: 48,4% (44,8-52%) frente a 29,3% (29-29,6%); CP ajustado=l,65 (1,42-1,93, P < 0,001). Comparados con la población de referencia, los sujetos con esquizofrenia o trastorno bipolar (TB), pero no los que tenían demencia, mostraron una prevalencia mayor de SM.

Conclusión.

Comparados con la población general de pacientes ambulatorios, la prevalencia de SM fue significativamente mayor en pacientes con esquizofrenia o TB tratados con antipsicóticos.

Keywords

Síndrome metabólicocriterios modificados del NCEP-ATP IIIAntipsicóticosTransversalBase de datos de atención primaria
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 15 , Issue 5 , June 2008 , pp. 219 - 227
Copyright
Copyright © European Psychiatric Association 2008

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