Document Detail


Low cardiorespiratory fitness and physical functional capacity in obese patients with schizophrenia.
MedLine Citation:
PMID:  21146958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Low cardiorespiratory fitness is a prominent behavioral risk factor for cardiovascular disease (CVD) morbidity and mortality, as cardiorespiratory fitness is strongly associated with CVD outcomes. High rates of CVD have been observed in the schizophrenia population, translating into a markedly reduced life expectancy as compared to healthy controls. Surprisingly however, while cardiorespiratory fitness is an eminent indicator for overall cardiovascular health as well as eminently modifiable risk factor for CVD, no studies have systematically assessed cardiorespiratory fitness in schizophrenia.
METHODS: Community-dwelling schizophrenia patients underwent graded-exercise tests, to ascertain maximal oxygen uptake (Max Vo2), considered to be the gold standard for the evaluation of cardiorespiratory fitness and physical functional capacity. The modified Bruce protocol was used to ascertain cardiorespiratory fitness and physical functional capacity; data was normalized and compared to population standards derived from the ACLS (Aerobics Center Longitudinal Study) and the National Health and Nutrition Examination Surveys (NHANES), Cycles III and IV.
RESULTS: Data for n=117 participants (41% male, 46% white) was analyzed. Mean age (y) was 43.2±9.9, and mean BMI was 37.2±7.3. Peak HR attained during exercise was 145.6±19.6, after 8.05±3.6 min, achieving 111.2±44.2W. Max Vo2 was 1.72±6.6l/min, MaxVCo2 1.85±7.2l/min, and minute ventilation (VE) was 55.6±21.9 ml/s. PANSS Positive subscores (13.3±4.4; r=-0.21, p=0.024) were inversely correlated with Max Vo2 ml(-1)min(-1) kg(-1). Neither PANSS Total (56.3±12.3; r=-0.105, p=0.72), PANSS Negative (14±5.1; r=-0.52, p=0.57) nor PANSS General Psychopathology (28.4±7.4; r=-0.28, p=0.76) scores were correlated with Max Vo2 ml(-1) min(-1) kg(-1). Peak heart rate and duration of exercise were not correlated with PANSS scores. Compared to healthy controls derived from the ACLS and NHANES, respectively, 115 participants achieved 'low levels' of fitness only, as well as highly significantly reduced Max Vo2, across all age groups.
CONCLUSION: The test was generally well received and tolerated by those who elected to participate; and adherence to the protocol was good. Among participants with schizophrenia, most of whom were obese, and across all age groups, cardiorespiratory fitness was exceedingly poor. Only two participants in our entire sample fit the categorization of 'moderate fitness level'; that is, a fitness level at or above the 20th percentile of ACLS-derived population comparisons. Conversely, this left 98.3% of participants with schizophrenia below population standards. Low cardiorespiratory fitness emerges as an eminent modifiable risk factor for CVD mortality and morbidity in schizophrenia complicated by obesity.
Authors:
Martin Strassnig; Jaspreet S Brar; Rohan Ganguli
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-12-13
Journal Detail:
Title:  Schizophrenia research     Volume:  126     ISSN:  1573-2509     ISO Abbreviation:  Schizophr. Res.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-01     Completed Date:  2011-06-24     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  8804207     Medline TA:  Schizophr Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  103-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Affiliation:
University of Toronto, Center for Addiction and Mental Health, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiovascular Diseases / diagnosis,  etiology*
Child
Exercise Test
Female
Heart Rate / physiology*
Humans
Longitudinal Studies
Male
Middle Aged
Obesity / complications*
Oxygen Consumption / physiology
Physical Fitness / physiology*
Pulmonary Ventilation / physiology*
Residence Characteristics
Retrospective Studies
Risk Factors
Schizophrenia / complications*
Sex Factors
Young Adult
Grant Support
ID/Acronym/Agency:
1P30DK46204/DK/NIDDK NIH HHS; 5M01RR00056/RR/NCRR NIH HHS; R01 MH066068-01A2/MH/NIMH NIH HHS; R01 MH66068/MH/NIMH NIH HHS

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