Brief Report Predictive utility of blood pressure, waist circumference and body mass index for metabolic syndrome in patients with schizophrenia in Singapore Milawaty Nurjono 1 and Jimmy Lee 1,2 1 Research Division, Institute of Mental Health, Singapore, Singapore and 2 Department of General Psychiatry, Institute of Mental Health, Singapore, Singapore Corresponding author: Dr Jimmy Lee, Institute of Mental Health, 10 Buangkok View, Singapore 539747, Singapore. Email: jimmy_lee@imh.com.sg Received 22 November 2011; accepted 4 May 2012 Abstract Aims: This study aims to examine and compare the predictive utility of blood pressure (BP), waist circum- ference (WC) and body mass index (BMI), and to determine optimal cut- off values in prediction of metabolic syndrome (MetS) in patients with chronic schizophrenia. Methods: About 100 patients with chronic schizophrenia were recruited. BMI and BP were measured and laboratory tests to evaluate patients’ high-density lipoprotein cholesterol, triglycerides and glucose levels were performed. Presence of MetS was examined according to AHA/NHLBI guidelines. Predictive utility of BP, WC and BMI was examined using receiver operating curve and discriminant indices were determined accordingly. Results: Forty-six (46%) patients were identified to have MetS. BMI of 23 kg m -2 was most accurate (AUC = 0.83, P < 0.001), with sensitiv- ity of 93.5%, specificity of 48.1%, positive predictive value of 60.6% and negative predictive value of 92.9% in identifying MetS. Conclusion: This finding has immedi- ate and significant clinical implica- tions in the local population with schizophrenia. Key words: blood pressure, body mass index (BMI), metabolic syndrome, schizophrenia, waist circumference. INTRODUCTION Metabolic syndrome (MetS), as characterized by increased visceral adiposity, hyperglycaemia, hyper- tension and hyperlipidaemia, is highly prevalent in patients with schizophrenia. 1 This has been attri- buted to patients’ unhealthy lifestyles, 2,3 possible genetic predisposition to metabolic dysregula- tions 4,5 and exposure to antipsychotic medica- tions. 6,7 Although the exact pathogenesis of MetS is unclear, it has been consistently shown to be a risk factor for the development of cardiovascular diseases. 8–10 Studies have also reported increased mortality rate due to cardiovascular causes in patients with schizophrenia. 11–13 The criterion symp- toms of MetS are potentially modifiable through changes in lifestyle and diet, or pharmacological management of hyperglycaemia, hyperlipidaemia and obesity. Therefore, MetS has attracted much clinical attention with the aims of early identifica- tion and intervention. Routine laboratory screening for metabolic disor- ders as recommended for patients with schizophre- nia currently taking antipsychotic medications is often not performed 14 commonly suggested to be due to the cost and discomfort associated with blood collection. 15 These limitations have prompted attempts to identify alternative reliable and easily obtainable screening tools for MetS. Body mass index (BMI), a measure of body fat, and waist cir- cumference (WC), a measure of central adiposity, have been proposed to be potentially useful in the prediction of MetS in various populations with or without schizophrenia. 15,16 Therefore, this study aims to examine and compare the predictive utility of easily obtainable Early Intervention in Psychiatry 2012; ••: ••–•• doi:10.1111/j.1751-7893.2012.00384.x First Impact Factor released in June 2010 and now listed in MEDLINE! © 2012 Blackwell Publishing Asia Pty Ltd 1