Beware of PHATS in metabolic syndrome

Making time to monitor all five risk factors for metabolic syndrome can be challenging in a busy psychiatric setting. But with higher prevalence in persons with psychiatric disorders and/or taking psychotropics,¹ this precursor for type 2 diabetes and cardiovascular disease demands your attention.² The mnemonic PHATS can help you monitor metabolic syndrome risk factors thoroughly and quickly (Table).

Based on National Cholesterol Education Program (NCEP) criteria,³ patients with three of five PHATS elements have metabolic syndrome. A recent study of patients taking atypical antipsychotics suggests that abdominal obesity and elevated fasting blood glucose might be the most accurate and cost-effective indicators; combining these two factors correctly identified 100% of patients with metabolic syndrome.⁴ Until additional studies can confirm this finding, use NCEP guidelines—the basis for PHATS.

You can easily monitor for metabolic syndrome with a blood pressure cuff, a tape measure, and periodic blood glucose and lipid profiles. An extra minute or two can help prevent metabolic complications in at-risk patients.

Table

PHATS: 3 of 5 positive criteria indicate metabolic syndrome