There is a growing interest in low-grade inflammatory and metabolic alterations in patients with chronic schizophrenia (SCH).

Inflammatory (tumor-necrosis factor-α [TNF-α], interferon-γ [IFN-γ], interleukins [IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10], monocyte chemo-attractant protein-1 [MCP-1]) and growth factors (vascular endothelial growth factor [VEGF], epidermal growth factor [EGF]) were measured in blood serum samples of 105 SCH patients and 148 control subjects (CS). Simultaneously the clinical biomarkers (C-reactive protein [CRP], triglycerides [TG], low-density lipoprotein [LDL-c] and high-density lipoprotein [HDL-c] cholesterol, glycated hemoglobin [HbA1c]) were measured, and body mass index (BMI) was calculated for patients.

Several cyto-/chemokines (IFN-γ, MCP-1, IL-2, IL-6, IL-8 and IL-10) were significantly (P < 0.0000001) elevated in SCH patients compared to CS. Odds ratios, obtained from logistic regression analyses, were significantly elevated for IL-2, IL-6, IL-10, INF-γ, and decreased for TNF-α in SCH group. Among the patients, higher IL-2, IL-6, INF-γ and lower MCP-1 levels as well as male gender were together significant (P < 0.000001) predictors of higher HbA1c levels, and TG/HDL-c parameter was associated with ratios of INF-γ/IL-10 (P = 0.004), and INF-γ/IL-4 (P = 0.049), HbA1c (P = 0.005), INF-γ (P = 0.009), as well as LDL-c (P = 0.02) levels.

IL-2, IL-6, IL-10 and IFN-γ were the most significant SCH-related markers among the measured cytokines in our patient group. Furthermore, significant associations between pro-/anti-inflammatory imbalance and HbA1c as well as cardio-metabolic risk marker (TG/HDL-c) were observed, indicating higher risks of diabetes and cardiovascular diseases among SCH patients.

BMI and waist circumference (WC) are used to screen for cardio-metabolic risk; however it is unclear how well these indices perform in populations subject to childhood stunting.

To evaluate BMI and WC as indicators of cardio-metabolic risk and to determine optimal cut-off points among 1325 Guatemalan adults (44 % stunted: ≤150 cm women; ≤162 cm men).

Cardio-metabolic risk factors were systolic/diastolic blood pressure ≥130/≥85 mmHg, glucose ≥5·5 mmol/l, TAG ≥1·7 mmol/l, ratio of total cholesterol to HDL-cholesterol ≥5·0, and the presence of two or more and three or more of the preceding risk factors. Receiver operating characteristic (ROC) curve analysis was used.

Areas under the ROC curve were in the range of 0·59–0·77 for BMI and 0·59–0·78 for WC among men and 0·66–0·72 and 0·64–0·72 among women, respectively. Optimal cut-off points for BMI were 24·7–26·1 kg/m2 among men (24·5–26·1 kg/m2 stunted; 24·8–26·3 kg/m2 non-stunted) and 26·5–27·6 kg/m2 among women (26·3–27·8 kg/m2 stunted; 26·6–27·9 kg/m2 non-stunted). Optimal cut-off points for WC were 87·3–91·1 cm among men (85·3–89·4 cm stunted; 88·5–93·3 cm non-stunted) and 91·3–95·3 cm among women (90·9–94·4 cm stunted; 91·8–95·6 cm non-stunted).

Optimal cut-off points for BMI were slightly higher among women than men with no meaningful differences by stature. Optimal cut-off points for WC were several centimetres lower for stunted compared with non-stunted men, and both were substantially lower than the current recommendations among Western populations. Cut-off points derived from Western populations may not be appropriate for developing countries with a high prevalence of stunting.