La evaluación de factores de riesgo y el asesoramiento durante 12 meses reduce el riesgo metabólico y cardiovascular en pacientes con trastornos del espectro esquizofrénico con sobrepeso u obesidad: Estudio CRESSOB / Risk factor assessment and counselling for 12 months reduces metabolic and cardiovascular risk in overweight or obese patients with schizophrenia spectrum disorders: The CRESSOB study

RESUMEN

Introducción. Se ha asociado la presencia del síndrome metabólico (SM) y de factores de riesgo cardiovascular (FRC) a pacientes con esquizofrenia. El principal objetivo es evaluar la evolución de los FRC y la prevalencia del SM durante 12 meses en una cohorte de pacientes con sobrepeso diagnosticados de esquizofrenia esquizofreniforme o de trastorno esquizoafectivo a la que se aplicaron las recomendaciones para la evaluación y control del riesgo cardiovascular. Método. El estudio del control del riesgo metabólico y cardiovascular en pacientes con esquizofrenia y sobrepeso [Control of Metabolic and Cardiovascular Risk in Patients with Schizophrenia and Overweight (CRESSOB)] es un estudio de 12 meses, observacional, prospectivo, abierto, multicéntrico, naturalístico que incluye 109 centros de salud mental en España. El estudio incluyo un total de 403 pacientes, de los cuales se recopilaron todas las variables relacionadas con FRC y SM en 366 pacientes. De esos 366, 286 completaron el seguimiento, (basal, a los 3, 6 y 12 meses) en el que se llevaron a cabo un examen físico completo y una analítica de sangre (glucosa, colesterol y triglicéridos), se les preguntó sobre hábitos de salud (tabaco, dieta y ejercicio) y se les ofreció una serie de recomendaciones para prevenir el riesgo cardiovascular y el SM. Resultados. Un total de 403 pacientes fueron incluidos en el estudio, 63% hombres, de mediana edad [media 40,5 años; DE (10,5)]. Transcurridos 12 meses, el estudio mostró descensos estadísticamente significativos en el peso

ABSTRACT

Background. Metabolic syndrome (MS) and cardiovascular risk factors (CRF) have been associated with patients with schizophrenia. The main objective is to assess the evolution of CRF and prevalence of MS for 12 months in a co hort of overweight patients diagnosed with schizophrenia schizophreniform disorder or schizoaffective disorder in which the recommendations for the assessment and control of metabolic and cardiovascular risk were applied. Methods. The Control of Metabolic and Cardiovascular Risk in Patients with Schizophrenia and Overweight (CRESSOB) study is a 12-month, observational, prospective, open-label, multicentre, naturalistic study including 109 community mental health clinics of Spain. The study included a total of 403 patients, of whom we could collect all variables related to CRF and MS in 366 patients. Of these 366 patients, 286 completed the follow-up, (baseline, months 3, 6 and 12) where they underwent a complete physical examination and a blood test (glucose, cholesterol and triglycerides), they were asked about their health-related habits (smoking, diet and exercise) and they were given a series of recommendations to prevent cardiovascular risk and MS. Results. A total of 403 patients were included, 63% men, mean age (mean; (SD)) 40.5 (10.5) years. After 12 months, the study showed statistically significant decrease in weight (p<0.0001) waist circumference (p<0.0001), BMI (p<0.0001), HDL colesterol (p=0.02), LDL colesterol (p=0.0023) and triglycerides (p=0.0005). There was a significant reduction in the percentage of smokers (p=0.0057) and in the risk of heart disease at 10 years (p=0.0353). Conclusion. Overweight patients with schizophrenia who receive appropriate medical care, including CRF monitoring and control of health-related habits experience improvements with regard to most CRFs