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The prevalence and independent influencing factors of obesity and underweight in patients with schizophrenia: a multicentre cross-sectional study

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Abstract

Background

Few studies have investigated the weight of patients with schizophrenia in China.

Objective

The aim of this study was to analyse the prevalence, clinical characteristics and influencing factors of obesity and underweight in patients with chronic schizophrenia in China.

Methods

A total of 325 patients with schizophrenia and 172 sex- and age-matched healthy controls from the community were recruited. Socio-demographic data and laboratory measurements were collected for all subjects. Using the Positive and Negative Syndrome Scale (PANSS), we evaluated the psychiatric symptoms of patients with schizophrenia. According to the body mass index (BMI) criteria in China, BMI ≥ 28 kg/m2 indicates obesity, and BMI < 18.5 kg/m2 indicates underweight.

Results

Of the patients with schizophrenia, 16.3% were obese, and 6.8% were underweight; 11.0% of the healthy controls were obese, and 3.5% were underweight. There was no difference between the two groups in the prevalence of obesity and underweight. After controlling for relevant variables, the obesity rate remained non significant, but the underweight rate appeared to be different. The multinomial regression analysis revealed that among the patients with schizophrenia, female sex, triglyceride level and LDL level were independent risk factors for obesity and that HDL level was an independent protective factor against obesity. In contrast, male sex and HDL level were independent risk factors for underweight.

Conclusion

We found that the patients with schizophrenia had an increased rate of underweight and some factors related to weight.

Level of evidence

Level V, descriptive study

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Acknowledgements

The authors thank all the staff from Chaohu Hospital of Anhui Medical University, Hefei Fourth People’s Hospital and Ma’anshan Fourth People’s Hospital for their help. In addition, the authors thank American Journal Experts for helping to modify the language.

Funding

This study was funded by grants from the National Natural Science Foundation of China (81771449, 81801341), Key Research and Development Projects in Anhui Province (1804h08020263) and the Scientific Research Foundation of the Institute for Translational Medicine (2017zhyx17).

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Author notes

  1. Juan Wang, Yulong Zhang and Yating Yang have contributed equally to this article.

Authors and Affiliations

  1. Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui, China

    Juan Wang, Yulong Zhang, Yating Yang, Zhiwei Liu, Lei Xia, Kai Zhang & Huanzhong Liu

  2. Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, China

    Juan Wang, Yulong Zhang, Yating Yang, Zhiwei Liu, Lei Xia, Kai Zhang & Huanzhong Liu

  3. Department of Psychiatry, Hefei Fourth People’s Hospital, Hefei, Anhui, China

    Wenzheng Li

  4. Department of Psychiatry, Chengdu Fourth People’s Hospital, Chengdu, Sichuan, China

    Zhongxiang Li

  5. Laboratory of Brain Stimulation and Biological Psychiatry, Second People’s Hospital of Huizhou, Huizhou, Guangdong, China

    Xinhui Xie & Wenfeng Deng

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  1. Juan Wang
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Correspondence to Kai Zhang or Huanzhong Liu.

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The authors have no conflicts of interest to disclose.

Ethical approval

This study obtained approval from the Medical Ethics Committee of Chaohu Hospital of Anhui Medical University (201805-kyxm-03) and in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

If patients with schizophrenia and participants from the community could communicate, were willing to accept an approximately 1-h interview and allow collection of blood samples after understanding the procedures and purpose of the study, they could participate in this study. All subjects or their guardians signed an informed consent form.

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This study was registered in the china Clinical Trial Registration Center (chiCTR 1800017044).

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Wang, J., Zhang, Y., Yang, Y. et al. The prevalence and independent influencing factors of obesity and underweight in patients with schizophrenia: a multicentre cross-sectional study. Eat Weight Disord 26, 1365–1374 (2021). https://doi.org/10.1007/s40519-020-00920-9

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