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Increased Silent Brain Infarction Accompanied With High Prevalence of Diabetes and Dyslipidemia in Psychiatric Inpatients: A Cross-Sectional Study

Tetsuto Kanzaki, MD, PhD; Yoriyasu Uju, MD; Keisuke Sekine, MD; Yukihiro Ishii, MD; Taro Yoshimi, MD; Reiko Yasui, MD; Asuka Yasukawa, MD; Mamoru Sato, MD; Seiko Okamoto, MD; Tetsuya Hisaoka, MD; Masafumi Miura, MD; Shun Kusanishi, MD; Kanako Murakami, MD; Chieko Nakano, MD; Yasuhiko Mizuta, MD; Seisuke Mimori, PhD; Shunichi Mishima, MD, PhD; Kazuei Igarashi, PhD; Tsuyoshi Takizawa, PhD; Tatsuro Hayakawa, MD, PhD; and Kazumi Tsukada, MD, PhD

Published: March 26, 2015

Article Abstract

Objective: Patients with schizophrenia have increased risk of atherosclerotic diseases. It is already known that lifestyle-related disorders and the use of antipsychotics are closely related with the progression of atherosclerosis in psychiatric patients. Stroke as well as coronary heart disease play an important role in the cause of death in Asia and Japan. Thus, we studied the prevalence of cerebrovascular disease in psychiatric inpatients in Japan using brain magnetic resonance imaging (MRI).

Method: This cross-sectional study was performed from January 2012 to December 2013. Study participants were 152 hospitalized patients (61 men and 91 women) in the Department of Psychiatry at Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa City, Japan. Mean ages were 50.0 and 57.1 years old for men and women, respectively. The diagnoses (DSM-IV-TR criteria) of participants were schizophrenia (69.1%), mood disorder (18.4%), and other mental disorders (12.5%). We checked physical status, metabolic status of glucose and lipid levels, and brain MRI within 1 week of admission.

Results: The study group showed a significantly high prevalence of diabetes and low high-density lipoprotein (HDL) cholesterolemia in both sexes (n = 61 in men, n = 91 in women, P < .05). In the study group, serum fasting plasma glucose and hemoglobin A1c levels were significantly high (n = 152, P < .05), but serum HDL cholesterol and total cholesterol were significantly low in both sexes (n = 61 in men, n = 90 in women, P < .05), and triglycerides were low in men (n = 61, P < .05). Silent brain infarction was recognized at a higher rate (n = 98, P < .05) compared with healthy controls.

Conclusions: Participants in this study had an increased ratio of silent brain infarction compared with Japanese healthy controls, accompanied with higher ratios of diabetes and low HDL cholesterol.

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