Davy Vancampfort1, Mats Hallgren2, James Mugisha3, Marc De Hert4, Michel Probst5, Dirk Monsieur4, Brendon Stubbs6. 1. KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium Davy.Vancampfort@uc-kortenberg.be. 2. Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden. 3. Butabika National Referral and Mental Health Hospital, Kampala, Uganda Kyambogo University, Kampala, Uganda. 4. KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium. 5. KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium. 6. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
Abstract
AIMS: People with alcohol use disorders (AUDs) have a double increased risk for cardiovascular diseases (CVD) and associated premature mortality. Metabolic syndrome (MetS) and its components are highly predictive of CVD. The primary aim of this meta-analysis was to describe pooled rates of MetS and its components in people with AUDs taking into account variations in demographic and clinical variables. METHODS: Medline, Embase and CINAHL were searched until 03/2016 for cross-sectional and baseline data of longitudinal studies in adults with AUDs. Two independent reviewers extracted data. Random effects meta-analysis with a relative risk, subgroups and meta-regression analyses were employed. RESULTS: The pooled MetS prevalence after adjusting for publication bias was 21.8% (95% CI = 19.1%-24.8%; N studies = 5; n participants = 865; age range = 34.8-51.1 years). Abdominal obesity was observed in 38.3% (N = 4, n = 389; 95%CI = 30.2%-47.0%), hyperglycemia in 14.3% (N = 4, n = 389; 95% CI = 3.7%-42.3%), hypertriglyceridemia in 43.9% (N = 4, n = 389; 95% CI = 31.7%-56.8%), low high-density lipoprotein cholesterol in 7.6% (N = 4, n = 389; 95% CI = 4.3%-13.2%) and hypertension in 46.5% (95% CI = 21.7%-73.1%). The MetS prevalence was similar across settings. A separate meta-regression analysis revealed that a higher MetS frequency was moderated by a higher percentage of psychiatric co-morbidity (coefficient = 3.651; standard error = 1.10, 95% CI = 1.50 to 5.80, z = 3.3, P < 0.001), CONCLUSIONS: Routine screening and multidisciplinary management of metabolic abnormalities in people with AUD is needed. Special attention should be given to people with AUDs with psychiatric co-morbidities. Future research should focus on how cardio-metabolic outcomes are moderated by clinical characteristics. SHORT SUMMARY: The metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. Our meta-analysis demonstrates that more than 1 in 5 persons with alcohol use disorder (AUDs) has the MetS. Routine screening and multidisciplinary management of metabolic abnormalities should be an integral part of the multidisciplinary treatment of AUDs.
AIMS: People with alcohol use disorders (AUDs) have a double increased risk for cardiovascular diseases (CVD) and associated premature mortality. Metabolic syndrome (MetS) and its components are highly predictive of CVD. The primary aim of this meta-analysis was to describe pooled rates of MetS and its components in people with AUDs taking into account variations in demographic and clinical variables. METHODS: Medline, Embase and CINAHL were searched until 03/2016 for cross-sectional and baseline data of longitudinal studies in adults with AUDs. Two independent reviewers extracted data. Random effects meta-analysis with a relative risk, subgroups and meta-regression analyses were employed. RESULTS: The pooled MetS prevalence after adjusting for publication bias was 21.8% (95% CI = 19.1%-24.8%; N studies = 5; n participants = 865; age range = 34.8-51.1 years). Abdominal obesity was observed in 38.3% (N = 4, n = 389; 95%CI = 30.2%-47.0%), hyperglycemia in 14.3% (N = 4, n = 389; 95% CI = 3.7%-42.3%), hypertriglyceridemia in 43.9% (N = 4, n = 389; 95% CI = 31.7%-56.8%), low high-density lipoprotein cholesterol in 7.6% (N = 4, n = 389; 95% CI = 4.3%-13.2%) and hypertension in 46.5% (95% CI = 21.7%-73.1%). The MetS prevalence was similar across settings. A separate meta-regression analysis revealed that a higher MetS frequency was moderated by a higher percentage of psychiatric co-morbidity (coefficient = 3.651; standard error = 1.10, 95% CI = 1.50 to 5.80, z = 3.3, P < 0.001), CONCLUSIONS: Routine screening and multidisciplinary management of metabolic abnormalities in people with AUD is needed. Special attention should be given to people with AUDs with psychiatric co-morbidities. Future research should focus on how cardio-metabolic outcomes are moderated by clinical characteristics. SHORT SUMMARY: The metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. Our meta-analysis demonstrates that more than 1 in 5 persons with alcohol use disorder (AUDs) has the MetS. Routine screening and multidisciplinary management of metabolic abnormalities should be an integral part of the multidisciplinary treatment of AUDs.
Authors: Přemysl Mladěnka; Lenka Applová; Jiří Patočka; Vera Marisa Costa; Fernando Remiao; Jana Pourová; Aleš Mladěnka; Jana Karlíčková; Luděk Jahodář; Marie Vopršalová; Kurt J Varner; Martin Štěrba Journal: Med Res Rev Date: 2018-01-05 Impact factor: 12.944