The high pooled prevalence of metabolic syndrome (31.4%) among Chinese patients with schizophrenia underscores the need for routine metabolic monitoring and targeted cardiovascular prevention strategies in this population.
Premature mortality in schizophrenia is associated with comorbidity with metabolic syndrome (MetS). In China, existing studies have reported inconsistent findings regarding the prevalence of MetS among patients with schizophrenia, with limited nationally representative epidemiological data. This meta-analysis aimed to (1) determine the pooled prevalence of MetS in a Chinese population with schizophrenia and (2) systematically evaluate subgroup disparities across demographic, clinical, and treatment-related variables. The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Journal Integration Platform, and China Biology Medicine databases were searched for cross-sectional studies on the prevalence of MetS in China, without any search restrictions. Subgroup analyses were performed according to first-episode status, sex, age group, marital status, educational level, illness duration, body mass index (BMI), smoking history, alcohol-use history, family history of schizophrenia/diabetes/hypertension, and medication history. We included 73 studies with a total sample size of 34,655 patients with schizophrenia, including 10,944 patients with MetS. The pooled analysis revealed a combined prevalence of schizophrenia and MetS in China of 31.4% (95% confidence interval: 28.8–34.0). There were significantly elevated risks of MetS observed in older adults (≥50 years), prolonged hospitalization, longer illness duration ( > 10 years), higher BMI, family history of diabetes, and smokers. No significant differences in the prevalence of MetS were observed between groups according to sex, marital status, educational attainment, alcohol consumption, family history of schizophrenia or hypertension, use of first- or second-generation agents, and monotherapy or combination therapy with antipsychotics. This meta-analysis revealed a pooled prevalence of MetS of 31.4% among Chinese patients with schizophrenia. Given the heightened risk of cardiovascular morbidity and mortality associated with MetS in patients with schizophrenia, particularly in the subgroups of older adults, prolonged hospitalization, longer illness duration, higher BMI, family history of diabetes, and smokers, our study indicates the following interventions: (1) universal screening: routine metabolic monitoring integrated into psychiatric care protocols, (2) precision prevention: targeted interventions for high-risk subgroups (e.g., BMI management in obese patients and smoking cessation programs), (3) and nutritional empowerment: structured dietary education to improve metabolic health and potentially augment cognitive functioning. Not applicable.
Feng et al. (Thu,) studied this question.
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