The Prevalence of Metabolic Syndrome in Alcohol Use Disorders: A Systematic Review and Meta-analysis.

Davy Vancampfort, Mats Hallgren, James Mugisha, Marc De Hert, Michel Probst, Dirk Monsieur, Brendon Stubbs

Journal: Alcohol and alcoholism (Oxford, Oxfordshire) 2017;51(5):515-21

PMID: 27337988

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.

© The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Address: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium [email protected].; Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden.; Butabika National Referral and Mental Health Hospital, Kampala, Uganda Kyambogo University, Kampala, Uganda.; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium.; KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.; 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.
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