Waist-Height ratio Highlights Detrimental Risk for Olanzapine Associated Weight Gain Earlier than Body Mass Index.

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Badamasi Mohammed Ibrahim, Abiola Tajudeen, Owolabi Desola Shakirat, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4647433/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Patients with psychotic mental disorders, including schizophrenia, often exhibit poor dietary choices and low levels of physical activity, contributing to a higher prevalence of obesity compared to the general population. This study recruited 100 patients diagnosed with schizophrenia who had been receiving Olanzapine antipsychotic medication for at least three months, alongside 100 healthy volunteers for comparison. The average age of the schizophrenia patients was 35.56 ± 9.95 years, with a higher proportion of females in both groups. Our findings revealed significantly higher rates of abnormal Body Mass Index (BMI) (X² = 17.06, P = 0.000036; OR = 4.58, CI = 2.16–9.74) and abnormal waist-height ratio (WHtR) (X² = 35.57, P = 2.46E-9; OR = 6.37, CI = 3.39–12.00) among the schizophrenia patients compared to the healthy volunteers. Notably, BMI identified 43.3% of the schizophrenia patients as having concerning weight changes, whereas WHtR identified 64.7%, indicating that WHtR is a more sensitive measure. This discrepancy means that an additional 21.4% of schizophrenia patients would benefit from weight management guidance based on WHtR rather than BMI. Our results underscore the critical importance of WHtR in assessing adiposity among schizophrenia patients treated with Olanzapine, highlighting its value as a tool for monitoring and managing cardiometabolic risks in this population. Anthropology Cognitive Neuroscience Schizophrenia Olanzapine Obesity Body Mass Index (BMI) Waist-height ratio (WHtR) Introduction There are numerous clinical conditions including cardiovascular diseases, Type 2 diabetes mellitus and sleep apnea that have been associated with obesity 1 . Patients with psychotic mental disorders including schizophrenia are known to have poor dietary choices with low level of physical activities; these characteristic may underscore the high rate of obesity among patients with mental disorder when compared to population estimates 2, 3 . Treatment of many mental disorders including schizophrenia are liberally done using different antipsychotic (neuroleptics) and each of the medications are characteristically unique in there spectrum of adverse drug reactions 4 . First generation or traditional antipsychotics were commonly associated with extra-pyramidal side effects, which limits its prescription and compliance. The long-term use of newer antipsychotic medications can affect physical health adversely (weight gain and metabolic problems) 5 . Olanzapine was the most common antipsychotic attributed with extreme weight gain (> 7%) in 9 out 10 adolescent patients 6 . Weight gain in itself may not a problem, since it may reflect an improvement of health status from mental disorder and its associated disruption in eating habit. The distribution of the adipose tissues has been identified as the real danger and clinical culprit associated with cardio-metabolic risk such as insulin resistance, dyslipidemia and some types of cancer (eg, breast, ovarian, prostate, liver, kidney, colon) 7–17 . The most common anthropometric measure utilized in assessing weight gain viz –a vis adiposity is the body mass index measure and this is because of its ease of calculation 18 . The body mass index (BMI) is categorized into four categories: underweight (< 18.5), normal (18.5-24.99), overweight (25-29.99) or obese ( 30 ) 19 (WHO,2019). Additional anthropometric measurements such as body circumferences (neck, waist, hip and limbs), skinfold thickness waist-to-hip ratio, waist to height ratio and weight-adjusted-weight index, a good determinant of intra-abdominal fat (‘central obesity’) have also been utilized in the literature 20– 25 . These additional anthropometric assessment can account for some important adiposity characteristics such as the location of body fat, its amount, its amount relative to muscle and/or the weight of the skeleton in tandem with gender, age and ethnicity 26–29 . The weight gain associated with olanzapine treatment had commonly been evaluated along the BMI paradigm. A thorough assessment of the weight changes relative to position of adiposity, gender, age among other features can only be ascertained by assessing other anthropometric features highlighted earlier, including waist-to-height ratio which could replace BMI 30–31 Dermatoglyphic features of fingertip print pattern, second: fourth digit ratio and digital ridge count are features that have been associated with different clinical phenomenon in the literature 32 . Thus, the dermatoglyphics features observed have always provided a quantitative and spatial characteristics that can putatively unmask a true phenotypic manifestation of the activities of a cluster of genes that may be key in the developmental processes in general 33, 34 . Thus, accessing the dermatoglyphics features along with other anthropometric features of adiposity, can unravel an endogenous linked phenotypic feature associated with the propensity for adiposity build-up related to olanzapine antipsychotic medication. Thus, behavioral weight control programs commenced along with the initiation of antipsychotic pharmacotherapy or switching of medications approach could be actively considered in at risk population 5 . Methodology The current study was part of a larger controlled cross-sectional association study involving schizophrenia patients and healthy volunteers. The detailed study design had been reported in an earlier publication. In summary, one hundred (100) patients diagnosed with Schizophrenia (psychotic) disease and receiving Olanzapine antipsychotic medications for at least 3 months were recruited. Another 100 apparently healthy volunteers – screened for mental illness using the brief psychiatric rating scale (BPRS) were also recruited. A team of doctors were coopted into the study for patients screening based on the study inclusion and exclusion criteria. Each of the potential study participant was informed about the study’s aim and objectives. Further clarification as relates to the study were done before patients were asked to give a written informed consent. The patients were assisted to fill up a socio-demographic feature and clinical characteristic questionnaires. The patients’ waist, hip and head circumferences were measured using stretchable tape rule. The second digit to fourth digit ratio as well as finger print pattern were also assessed in line with earlier studies (35, 36, 37) . Statistical analysis All the measured data were summarized as mean and standard deviation. Statistical assessment were done for continuous variables using the non-parametric assessment called Mann-whitney U. While categorical variables were assessed using chi-square. Ethics clearance: The research protocol was submitted to the research ethics committee of Bayero University for assessment and certification. The committee certified the research with ethics number NHREC/06/12/19/209. The ethics clearance was reviewed by hospital management and permission to conduct research was granted by the psychiatry department of the hospital. Results The socio-demographic and some clinical features of the study participants were assessed and summarized in Table 1 : Table 1 Socio-demographic and clinical features of Schizophrenia patients and healthy volunteers recruited at Aminu Kano Teaching Hospital Kano AGE All Sample Case(n = 107) Control (n = 103) Mean ± SD 28.86 ± 9.90 35.56 ± 9.95 22.16 ± 2.72 Min – Max 16–65 17–65 16–30 GENDER All Sample Case Control Male 95 44 (44.9%) 51 (46%) Female 112 54 (55.1%) 58 (53.2%) ETHNICITY All Sample Case Control Hausa 180 102 78 Others 9 1 8 MARITAL STATUS All Sample Case Control Single 146 53 93 Marital 62 56 6 EDUCATIONAL LEVEL All Sample Case Control Educated 194 95 99 Non-edu 12 12 0 Family history of Mental illness Yes - 36 (33.3%) - No - 72 (66.7%) - Duration of mental illness Acute illness - 8 (7.5%) - Chronic illness - 26 (24.3%) - The average age of the recruited schizophrenia patients was 35.56 ± 9.95 years. There were more females in both the patients arm (54 schizophrenia patients) of the study as well as the healthy volunteer arms (58 healthy volunteers) of the study. Many of the schizophrenia patients had family history of similar disease (33.3%) and a number of the schizophrenia patients had a chronic disease (24.3%) (Table 1 ). The average measures of the height weight and waist circumference of the schizophrenia patients and healthy volunteers were tabulated in Table 2 . Table 2 The average measures of the height, weight and waist circumference among schizophrenia and healthy volunteers Schizophrenia Healthy volunteers Remarks BMI (all) Normal 55 (56.7%) 66 (85.7%) X 2 = 17.06, P = 0.000036; OR = 4.58 CI = 2.16–9.74 Abnormal 42 (43.3%) 11 (14.3%) BMI (extremes) Normal (18.5–24.9) 55 (70.5%) 66 (92.9%) X 2 = 12.21, P = 0.00046; OR = 5.52, CI = 1.97–15.48 Abnormal (≥ 30) 23 (29.5%) 5 (7.1%) Waist-height ratio (all) Normal (0.00- 0.49) 36 (35.3%) 73 (77.7%) X 2 = 35.57, P = 2.46E-9; OR = 6.37 CI = 3.39–12.00 Abnormal (0.5- more) 66 (64.7%) 21 (22.3%) Waist-height ratio (extremes) Normal (0–0.49) 35 (57.4%) 70 (97.2%) X 2 = 31.54, P = 1.95E-8; OR = 26.00 CI = 5.83–115.87 Abnormal (0.6 - above) 26 (42.6%) 2 (2.8%) Waist circumference 89.56 ± 14.11 cm 78.78 ± 9.68 cm Z = − 6.12, P = 9.18E-10 Height 163.57 ± 16.26 cm 166.79 ± 11.84 cm Z = − 1.26, P = 0.209 Weight 67.93 ± 16.87 Kg 58.85 ± 11.53 Kg Z = -4.46, P = 0.000008 There were significantly more abnormal BMI (X 2 = 17.06, P = 0.000036; OR = 4.58 CI = 2.16–9.74) and abnormal waist-height ratio (X 2 = 35.57, P = 2.46E-9; OR = 6.37 CI = 3.39–12.00) among the schizophrenia patients when compared to the healthy volunteers (Table 2 ). Nevertheless, the BMI factor identified only 43.3% of the schizophrenia patients as having a measure of weight change to be worried about; the waist-height ratio factor identified 64.7% of the patients as having a weight change of concern. Thus, an extra 21.4% of the population schizophrenia patients would receive guidance on weight changes based on the waist-height ratio rather than the BMI assessment. In addition, there is a strong correlation between BMI features and waist – height ratio in both population of healthy volunteers and schizophrenia patients (Tables 3 and 4) Table 3 Spearman correlation between different anthropometric measurements among Schizophrenia patients’ receiving Olanzapine treatment BMI Waist-height ratio Waist circumference Height Right 2D:4D Left 2D:4D BMI 1.00 0.87** 0.79** -0.25** 0.07 0.24* Waist height ratio 1.00 0.87 ** -0.433 ** 0.155 0.370 ** Waist circumference 1.00 -0.016 0.123 0.227 * Height 1.00 -0.118 − 0.316 * Right 2D:4D 1.00 0.527 ** Left 2D:4D 1.00 BMI = body mass index; 2D = Second digit; 4D = fourth digit Table 3 Spearman correlation between different anthropometric measurements among healthy volunteers BMI Waist-height ratio Waist circumference Height Right 2D:4D Left 2D:4D BMI 1.00 0.681** 0.523 ** -0.127 0.103 -0.058 Waist height ratio 1.00 0.794 ** -0.116 0.105 0.049 Waist circumference 1.00 0.443 ** 0.133 -0.063 Height 1.00 0.068 -0.132 Right 2D:4D 1.00 0.290 ** Left 2D:4D 1.00 BMI = body mass index; 2D = Second digit; 4D = fourth digit The correlation coefficient (Spearman) was strongest in the population of schizophrenia patients (0.87) when compared to healthy volunteers (0.681) (Tables 3 and 4). Discussion The average age of the recruited schizophrenia patients was 35.56 ± 9.95 years; females are more in number (n = 54 (55.1%)) among the persons recruited with the disease. Many of the schizophrenia patients had family history of similar disease (33.3%) and a number of the patients had a chronic disease (24.3%). Assessment of the anthropometric features of waist circumference, weight and the indicis of waist–height ratio as well as body mass index were identified to be larger among the schizophrenia patients when compared to the healthy volunteers. The cross-sectional assessment of the anthropometric features of weight, height, waist circumferences as well as their indicis were on the higher values among the schizophrenia patients (except height) when compared to the healthy volunteers. The higher indicis of body mass index as well as waist-height ratio among the patients suggest that the adipose deposit in these group was putatively much more, and due to olanzapine medication when compared to the adipose level among healthy volunteers probably. Higher adipose tissue deposit have been associated with numerous medical disorders and metabolic syndrome 38,39 . A remarkable role of the position/location of adipose tissue in the pathogenesis of metabolic syndrome have dominated the recent literature 40, 41, 42 . Experimental evidence to strengthen the biology between anthropometric measurements and component biochemical features of metabolic syndrome such as fasting glucose (FPG), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and visceral adiposity index (VAI) have been established 43,44,45 . Adiposity features are commonly described using body mass index (BMI) which is categorized into four categories: underweight (< 18.5), normal (18.5-24.99), overweight (25-29.99) or obese ( 30) 46 . Waist-height ratio has been proposed by the National Institute for Health and Care Excellence as a better representative of adiposity measure when compared to BMI 47 . It was assessed as a ratio of waist circumference by height, both measurements in centimeters, as a simple screening tool, which holds great potential for diagnosis of early cardiometabolic risk 48–53 . The values of the WHtR (defining the degree of central adiposity) included: a ratio of 0.4 to 0.49, indicating no increased health risks while ratio of 0.5 and above were categorized as suggestive of increased health risks 47,49,53 . This cut off values have been associated with high sensitivity (98.5%) and specificity (83.4%) in males (sensitivity (88.9%) and specificity (86.0%) in females) to determination of cardiometabolic syndrome 54 . In the current study, the fidelity of the WHtR in identifying persons at increased health risk of metabolic risk when compared to BMI was very high and this increased fidelity was only identified among schizophrenia patients treated with olanzapine. Further scrutiny of the fidelity of the measurements revealed that many more at very high risk individuals were identified using the highest cut-off values for WHtR when compared to BMI. In addition, the measurement of WHtR and BMI were highly correlated especially among the schizophrenia patients. However, among the healthy volunteers, the performance (fidelity) of the BMI and WHtR in identifying increase adiposity was similar. Thus, the current result emphasizes an overwhelmingly important role of the WHtR in assessing adiposity among schizophrenia patients treated with olanzapine, since it identifies features of adiposity, which are risk for cardio-metabolic disease, earlier than the cosmopolitan BMI and /or waist circumference measurements 55 –58 . A future study that could leverage on association study designs previously reported for genomic or metabolomic features in recruited participants could be done to identify the factors that may predict the weight gain associated with olanzapine 59, 60 . Declarations Authorship Contribution Statement Badamasi Mohammed Ibrahim and Gudaji Ibrahim Mustapha contributed to the conceptualization, data curation, methodology, and validation of the study. BADAMASI Mohammed Ibrahim,Abiola Tajudeen, Owolabi Desola Shakirat, and Ojeahere Isioma Margaret were involved in conceptualization, data curation, formal analysis, investigation, and methodology. Additionally, Abiola Tajudeen, Owolabi Desola Shakirat, and Ojeahere Isioma Margaret contributed resources and participated in methodology. Declaration of competing interest All other authors declare no conflict of interest. Acknowledgement As a team, we extend our sincere appreciation to the Federal University of Health Sciences Azare for their generous support through the institution-based research grant. This funding has been instrumental in advancing our research endeavors. We also acknowledge research assistant like: Abdulazeem Muhammad Andujeh, Ibrahim Muhammad Dauda, Sirajo Umar Mujittapha who contributed to data capturing from study participants. References Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, Eckel RH, American Heart Association (2006) ; Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. 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Acta Paediatr 108(12):2296–2297 Yoo EG (2016) Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk. Korean J Pediatr 59(11):425–431 Badamasi IM, Maulidiani M, Lye MS, Ibrahim N, Shaari K, Stanslas JA (2022) Preliminary Nuclear Magnetic Resonance Metabolomics Study Identifies Metabolites that Could Serve as Diagnostic Markers of Major Depressive Disorder. Curr Neuropharmacol 20(5):965–982 Badamasi MI, Lye MS, Ibrahim N, Ling K-H, Stanslas J (2021) Serotonergic receptor gene polymorphism and response to selective serotonin reuptake inhibitors in ethnic Malay patients with first episode of major depressive disorder. Pharmacogenomics J. https://doi.org/10.1038/s41397-021-00228-6 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4647433","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":319703541,"identity":"b610aa0c-9e07-4055-b0b7-9f9834500875","order_by":0,"name":"Badamasi Mohammed Ibrahim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBUlEQVRIiWNgGAWjYBACA2YGBmYIMwFE2CQw8AApHhK0pBGhhQFVy2HCWszZuRMfF9Rsi+ZnT2D8XFBzPs/gzAHGB2/bGPLkHbBrsWzm3Ww849jt3Jk9D5ilgYxig7MNzIZz2xiKDQ/gcNhh3m3SPGy3czfcSGAAMRI3nGdgk+ZtY0jc2IBPy7/buftvJDD/5vl3DqSF/TdBLbxtQFskEkCGH0jccLaBjRmkZT4O74P9wtt3O3fGmYdt1rx9ycWSZw42S845J5G4AVeI8Z/d+Jjn2+3c/vbkw7d5vtnl8Z1JPvjhTZlN4nwcDkMCjA3IDAkGgwMEtaADecK2jIJRMApGwcgAAPFWX6Zw2k1SAAAAAElFTkSuQmCC","orcid":"","institution":"Bayero University Kano","correspondingAuthor":true,"prefix":"","firstName":"Badamasi","middleName":"Mohammed","lastName":"Ibrahim","suffix":""},{"id":319703542,"identity":"056782be-eb64-4456-9c80-777db6b94bb3","order_by":1,"name":"Abiola Tajudeen","email":"","orcid":"","institution":"Bayero University Kano","correspondingAuthor":false,"prefix":"","firstName":"Abiola","middleName":"","lastName":"Tajudeen","suffix":""},{"id":319703543,"identity":"88ab8389-2381-4a8a-8843-569fa712a13b","order_by":2,"name":"Owolabi Desola Shakirat","email":"","orcid":"","institution":"Department of Psychiatry Bayero University Kano.","correspondingAuthor":false,"prefix":"","firstName":"Owolabi","middleName":"Desola","lastName":"Shakirat","suffix":""},{"id":319703544,"identity":"8fbabf1c-3cab-4885-bb10-a4e7ca5087ff","order_by":3,"name":"Ojeahere Isioma Margaret","email":"","orcid":"","institution":"Department of Psychiatry University of Jos","correspondingAuthor":false,"prefix":"","firstName":"Ojeahere","middleName":"Isioma","lastName":"Margaret","suffix":""},{"id":319703545,"identity":"c20d4981-5485-4a41-8999-0d5b11015432","order_by":4,"name":"Asuku Abdullahi yusuf","email":"","orcid":"","institution":"Bayero University Kano","correspondingAuthor":false,"prefix":"","firstName":"Asuku","middleName":"Abdullahi","lastName":"yusuf","suffix":""},{"id":319703546,"identity":"05e04621-4a1a-49e1-9af3-bb235eb9362d","order_by":5,"name":"Sirajo Umar Mujittapha","email":"","orcid":"","institution":"Skyline University Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Sirajo","middleName":"Umar","lastName":"Mujittapha","suffix":""},{"id":319703547,"identity":"1473090d-b147-4651-a2ce-39c000e0e030","order_by":6,"name":"Gudaji Ibrahim Mustapha","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwklEQVRIiWNgGAWjYJACCQYeCTkGBh4StRiTqoWBIbGBaC26/WsMb/yQsUjfcPzswQcfGOzkdBsIaDG78cbYsodHInfDmbxkwxkMycZmBwhqOWMmwQPSciDHTJqH4UDiNmK0SP7hkUg3OP+GWC3ne4AqeSQSDG4QbwtbsbUMj4ThTKCnDGcYEOOX84c33nzbUyfPdz7H8MGHCjs5gloYJBIYGBh7GBgUwCoNCCkHAX6Q0h8MDPINxKgeBaNgFIyCEQkAZbdBS7BDEI8AAAAASUVORK5CYII=","orcid":"","institution":"Bayero University Kano, Nigeria.","correspondingAuthor":true,"prefix":"","firstName":"Gudaji","middleName":"Ibrahim","lastName":"Mustapha","suffix":""}],"badges":[],"createdAt":"2024-06-27 09:35:42","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4647433/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4647433/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":59459626,"identity":"41acba2b-dd00-49fb-9341-83508bff163c","added_by":"auto","created_at":"2024-07-02 04:49:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":539104,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4647433/v1/398822d3-f2f1-40ee-a0c8-2d86702e4007.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eWaist-Height ratio Highlights Detrimental Risk for Olanzapine Associated Weight Gain Earlier than Body Mass Index.\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThere are numerous clinical conditions including cardiovascular diseases, Type 2 diabetes mellitus and sleep apnea that have been associated with obesity\u003csup\u003e1\u003c/sup\u003e. Patients with psychotic mental disorders including schizophrenia are known to have poor dietary choices with low level of physical activities; these characteristic may underscore the high rate of obesity among patients with mental disorder when compared to population estimates \u003csup\u003e2, 3\u003c/sup\u003e. Treatment of many mental disorders including schizophrenia are liberally done using different antipsychotic (neuroleptics) and each of the medications are characteristically unique in there spectrum of adverse drug reactions\u003csup\u003e4\u003c/sup\u003e. First generation or traditional antipsychotics were commonly associated with extra-pyramidal side effects, which limits its prescription and compliance. The long-term use of newer antipsychotic medications can affect physical health adversely (weight gain and metabolic problems) \u003csup\u003e5\u003c/sup\u003e. Olanzapine was the most common antipsychotic attributed with extreme weight gain (\u0026gt;\u0026thinsp;7%) in 9 out 10 adolescent patients\u003csup\u003e6\u003c/sup\u003e. Weight gain in itself may not a problem, since it may reflect an improvement of health status from mental disorder and its associated disruption in eating habit. The distribution of the adipose tissues has been identified as the real danger and clinical culprit associated with cardio-metabolic risk such as insulin resistance, dyslipidemia and some types of cancer (eg, breast, ovarian, prostate, liver, kidney, colon) \u003csup\u003e7\u0026ndash;17\u003c/sup\u003e. The most common anthropometric measure utilized in assessing weight gain viz \u0026ndash;a vis adiposity is the body mass index measure and this is because of its ease of calculation \u003csup\u003e18\u003c/sup\u003e. The body mass index (BMI) is categorized into four categories: underweight (\u0026lt;\u0026thinsp;18.5), normal (18.5-24.99), overweight (25-29.99) or obese (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) \u003csup\u003e19\u003c/sup\u003e(WHO,2019). Additional anthropometric measurements such as body circumferences (neck, waist, hip and limbs), skinfold thickness waist-to-hip ratio, waist to height ratio and weight-adjusted-weight index, a good determinant of intra-abdominal fat (\u0026lsquo;central obesity\u0026rsquo;) have also been utilized in the literature \u003csup\u003e20\u0026ndash; 25\u003c/sup\u003e. These additional anthropometric assessment can account for some important adiposity characteristics such as the location of body fat, its amount, its amount relative to muscle and/or the weight of the skeleton in tandem with gender, age and ethnicity \u003csup\u003e26\u0026ndash;29\u003c/sup\u003e. The weight gain associated with olanzapine treatment had commonly been evaluated along the BMI paradigm. A thorough assessment of the weight changes relative to position of adiposity, gender, age among other features can only be ascertained by assessing other anthropometric features highlighted earlier, including waist-to-height ratio which could replace BMI \u003csup\u003e30\u0026ndash;31\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDermatoglyphic features of fingertip print pattern, second: fourth digit ratio and digital ridge count are features that have been associated with different clinical phenomenon in the literature \u003csup\u003e32\u003c/sup\u003e. Thus, the dermatoglyphics features observed have always provided a quantitative and spatial characteristics that can putatively unmask a true phenotypic manifestation of the activities of a cluster of genes that may be key in the developmental processes in general \u003csup\u003e33, 34\u003c/sup\u003e. Thus, accessing the dermatoglyphics features along with other anthropometric features of adiposity, can unravel an endogenous linked phenotypic feature associated with the propensity for adiposity build-up related to olanzapine antipsychotic medication. Thus, behavioral weight control programs commenced along with the initiation of antipsychotic pharmacotherapy or switching of medications approach could be actively considered in at risk population \u003csup\u003e5\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThe current study was part of a larger controlled cross-sectional association study involving schizophrenia patients and healthy volunteers. The detailed study design had been reported in an earlier publication. In summary, one hundred (100) patients diagnosed with Schizophrenia (psychotic) disease and receiving Olanzapine antipsychotic medications for at least 3 months were recruited. Another 100 apparently healthy volunteers \u0026ndash; screened for mental illness using the brief psychiatric rating scale (BPRS) were also recruited. A team of doctors were coopted into the study for patients screening based on the study inclusion and exclusion criteria. Each of the potential study participant was informed about the study\u0026rsquo;s aim and objectives. Further clarification as relates to the study were done before patients were asked to give a written informed consent. The patients were assisted to fill up a socio-demographic feature and clinical characteristic questionnaires. The patients\u0026rsquo; waist, hip and head circumferences were measured using stretchable tape rule. The second digit to fourth digit ratio as well as finger print pattern were also assessed in line with earlier studies \u003csup\u003e(35, 36, 37)\u003c/sup\u003e.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eAll the measured data were summarized as mean and standard deviation. Statistical assessment were done for continuous variables using the non-parametric assessment called Mann-whitney U. While categorical variables were assessed using chi-square.\u003c/p\u003e \u003cp\u003eEthics clearance:\u003c/p\u003e \u003cp\u003e The research protocol was submitted to the research ethics committee of Bayero University for assessment and certification. The committee certified the research with ethics number NHREC/06/12/19/209. The ethics clearance was reviewed by hospital management and permission to conduct research was granted by the psychiatry department of the hospital.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe socio-demographic and some clinical features of the study participants were assessed and summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic and clinical features of Schizophrenia patients and healthy volunteers recruited at Aminu Kano Teaching Hospital Kano\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAGE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAll Sample\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCase(n\u0026thinsp;=\u0026thinsp;107)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eControl (n\u0026thinsp;=\u0026thinsp;103)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.86\u0026thinsp;\u0026plusmn;\u0026thinsp;9.90\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.56\u0026thinsp;\u0026plusmn;\u0026thinsp;9.95\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMin \u0026ndash; Max\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026ndash;65\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u0026ndash;65\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16\u0026ndash;30\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGENDER\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eAll Sample\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eCase\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eControl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (44.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51 (46%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54 (55.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58 (53.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eETHNICITY\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eAll Sample\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eCase\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eControl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHausa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMARITAL STATUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eAll Sample\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eCase\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eControl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEDUCATIONAL LEVEL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eAll Sample\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eCase\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eControl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEducated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-edu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily history of Mental illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72 (66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of mental illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAcute illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChronic illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (24.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe average age of the recruited schizophrenia patients was 35.56\u0026thinsp;\u0026plusmn;\u0026thinsp;9.95 years. There were more females in both the patients arm (54 schizophrenia patients) of the study as well as the healthy volunteer arms (58 healthy volunteers) of the study. Many of the schizophrenia patients had family history of similar disease (33.3%) and a number of the schizophrenia patients had a chronic disease (24.3%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The average measures of the height weight and waist circumference of the schizophrenia patients and healthy volunteers were tabulated in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe average measures of the height, weight and waist circumference among schizophrenia and healthy volunteers\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSchizophrenia\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHealthy volunteers\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRemarks\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBMI (all)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55 (56.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66 (85.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;17.06, P\u0026thinsp;=\u0026thinsp;0.000036; OR\u0026thinsp;=\u0026thinsp;4.58 CI\u0026thinsp;=\u0026thinsp;2.16\u0026ndash;9.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbnormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (43.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBMI (extremes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003cp\u003e(18.5\u0026ndash;24.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55 (70.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66 (92.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;12.21, P\u0026thinsp;=\u0026thinsp;0.00046; OR\u0026thinsp;=\u0026thinsp;5.52, CI\u0026thinsp;=\u0026thinsp;1.97\u0026ndash;15.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbnormal (\u0026ge;\u0026thinsp;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (29.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (7.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWaist-height ratio (all)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003cp\u003e(0.00- 0.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (35.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73 (77.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;35.57, P\u0026thinsp;=\u0026thinsp;2.46E-9; OR\u0026thinsp;=\u0026thinsp;6.37 CI\u0026thinsp;=\u0026thinsp;3.39\u0026ndash;12.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbnormal\u003c/p\u003e \u003cp\u003e(0.5- more)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66 (64.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (22.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWaist-height ratio (extremes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal (0\u0026ndash;0.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (57.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70 (97.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;31.54, P\u0026thinsp;=\u0026thinsp;1.95E-8; OR\u0026thinsp;=\u0026thinsp;26.00 CI\u0026thinsp;=\u0026thinsp;5.83\u0026ndash;115.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbnormal (0.6 - above)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (42.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (2.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWaist\u003c/p\u003e \u003cp\u003ecircumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89.56 \u0026plusmn; 14.11 cm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78.78\u0026thinsp;\u0026plusmn;\u0026thinsp;9.68 cm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eZ\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;6.12, P\u0026thinsp;=\u0026thinsp;9.18E-10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e163.57\u0026thinsp;\u0026plusmn;\u0026thinsp;16.26 cm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e166.79\u0026thinsp;\u0026plusmn;\u0026thinsp;11.84 cm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eZ\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;1.26, P\u0026thinsp;=\u0026thinsp;0.209\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.93\u0026thinsp;\u0026plusmn;\u0026thinsp;16.87 Kg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.85\u0026thinsp;\u0026plusmn;\u0026thinsp;11.53 Kg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eZ = -4.46, P\u0026thinsp;=\u0026thinsp;0.000008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThere were significantly more abnormal BMI (X\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;17.06, P\u0026thinsp;=\u0026thinsp;0.000036; OR\u0026thinsp;=\u0026thinsp;4.58 CI\u0026thinsp;=\u0026thinsp;2.16\u0026ndash;9.74) and abnormal waist-height ratio (X\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;35.57, P\u0026thinsp;=\u0026thinsp;2.46E-9; OR\u0026thinsp;=\u0026thinsp;6.37 CI\u0026thinsp;=\u0026thinsp;3.39\u0026ndash;12.00) among the schizophrenia patients when compared to the healthy volunteers (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Nevertheless, the BMI factor identified only 43.3% of the schizophrenia patients as having a measure of weight change to be worried about; the waist-height ratio factor identified 64.7% of the patients as having a weight change of concern. Thus, an extra 21.4% of the population schizophrenia patients would receive guidance on weight changes based on the waist-height ratio rather than the BMI assessment. In addition, there is a strong correlation between BMI features and waist \u0026ndash; height ratio in both population of healthy volunteers and schizophrenia patients (Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e and 4)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSpearman correlation between different anthropometric measurements among Schizophrenia patients\u0026rsquo; receiving Olanzapine treatment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWaist-height ratio\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWaist circumference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRight 2D:4D\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLeft 2D:4D\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.87**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.79**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.25**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.24*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist height ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.87\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.433\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.370\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-0.016\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.227\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;0.316\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRight 2D:4D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.527\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft 2D:4D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eBMI\u0026thinsp;=\u0026thinsp;body mass index; 2D\u0026thinsp;=\u0026thinsp;Second digit; 4D\u0026thinsp;=\u0026thinsp;fourth digit\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSpearman correlation between different anthropometric measurements among healthy volunteers\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWaist-height ratio\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWaist circumference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRight 2D:4D\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLeft 2D:4D\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.681**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.523\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.058\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist height ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.794\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.443\u003c/b\u003e\u003csup\u003e\u003cb\u003e**\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.133\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e-0.063\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.132\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRight 2D:4D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.290\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft 2D:4D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eBMI\u0026thinsp;=\u0026thinsp;body mass index; 2D\u0026thinsp;=\u0026thinsp;Second digit; 4D\u0026thinsp;=\u0026thinsp;fourth digit\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe correlation coefficient (Spearman) was strongest in the population of schizophrenia patients (0.87) when compared to healthy volunteers (0.681) (Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e and 4).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe average age of the recruited schizophrenia patients was 35.56\u0026thinsp;\u0026plusmn;\u0026thinsp;9.95 years; females are more in number (n\u0026thinsp;=\u0026thinsp;54 (55.1%)) among the persons recruited with the disease. Many of the schizophrenia patients had family history of similar disease (33.3%) and a number of the patients had a chronic disease (24.3%). Assessment of the anthropometric features of waist circumference, weight and the indicis of waist\u0026ndash;height ratio as well as body mass index were identified to be larger among the schizophrenia patients when compared to the healthy volunteers.\u003c/p\u003e \u003cp\u003eThe cross-sectional assessment of the anthropometric features of weight, height, waist circumferences as well as their indicis were on the higher values among the schizophrenia patients (except height) when compared to the healthy volunteers. The higher indicis of body mass index as well as waist-height ratio among the patients suggest that the adipose deposit in these group was putatively much more, and due to olanzapine medication when compared to the adipose level among healthy volunteers probably. Higher adipose tissue deposit have been associated with numerous medical disorders and metabolic syndrome\u003csup\u003e38,39\u003c/sup\u003e. A remarkable role of the position/location of adipose tissue in the pathogenesis of metabolic syndrome have dominated the recent literature \u003csup\u003e40, 41, 42\u003c/sup\u003e. Experimental evidence to strengthen the biology between anthropometric measurements and component biochemical features of metabolic syndrome such as fasting glucose (FPG), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and visceral adiposity index (VAI) have been established \u003csup\u003e43,44,45\u003c/sup\u003e. Adiposity features are commonly described using body mass index (BMI) which is categorized into four categories: underweight (\u0026lt;\u0026thinsp;18.5), normal (18.5-24.99), overweight (25-29.99) or obese ( 30)\u003csup\u003e46\u003c/sup\u003e. Waist-height ratio has been proposed by the National Institute for Health and Care Excellence as a better representative of adiposity measure when compared to BMI \u003csup\u003e47\u003c/sup\u003e. It was assessed as a ratio of waist circumference by height, both measurements in centimeters, as a simple screening tool, which holds great potential for diagnosis of early cardiometabolic risk\u003csup\u003e48\u0026ndash;53\u003c/sup\u003e. The values of the WHtR (defining the degree of central adiposity) included: a ratio of 0.4 to 0.49, indicating no increased health risks while ratio of 0.5 and above were categorized as suggestive of increased health risks \u003csup\u003e47,49,53\u003c/sup\u003e. This cut off values have been associated with high sensitivity (98.5%) and specificity (83.4%) in males (sensitivity (88.9%) and specificity (86.0%) in females) to determination of cardiometabolic syndrome \u003csup\u003e54\u003c/sup\u003e. In the current study, the fidelity of the WHtR in identifying persons at increased health risk of metabolic risk when compared to BMI was very high and this increased fidelity was only identified among schizophrenia patients treated with olanzapine. Further scrutiny of the fidelity of the measurements revealed that many more at very high risk individuals were identified using the highest cut-off values for WHtR when compared to BMI. In addition, the measurement of WHtR and BMI were highly correlated especially among the schizophrenia patients. However, among the healthy volunteers, the performance (fidelity) of the BMI and WHtR in identifying increase adiposity was similar. Thus, the current result emphasizes an overwhelmingly important role of the WHtR in assessing adiposity among schizophrenia patients treated with olanzapine, since it identifies features of adiposity, which are risk for cardio-metabolic disease, earlier than the cosmopolitan BMI and /or waist circumference measurements \u003csup\u003e55 \u0026ndash;58\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eA future study that could leverage on association study designs previously reported for genomic or metabolomic features in recruited participants could be done to identify the factors that may predict the weight gain associated with olanzapine\u003csup\u003e59, 60\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthorship Contribution Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBadamasi Mohammed Ibrahim and Gudaji Ibrahim Mustapha contributed to the conceptualization, data curation, methodology, and validation of the study. BADAMASI Mohammed Ibrahim,Abiola Tajudeen, Owolabi Desola Shakirat, and Ojeahere Isioma Margaret were involved in conceptualization, data curation, formal analysis, investigation, and methodology. Additionally, Abiola Tajudeen, Owolabi Desola Shakirat, and Ojeahere Isioma Margaret contributed resources and participated in methodology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of competing interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll other authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs a team, we extend our sincere appreciation to the Federal University of Health Sciences Azare for their generous support through the institution-based research grant. This funding has been instrumental in advancing our research endeavors. We also acknowledge research assistant like: Abdulazeem Muhammad Andujeh, Ibrahim Muhammad Dauda, Sirajo Umar Mujittapha who contributed to data capturing from study participants.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePoirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, Eckel RH, American Heart Association (2006) ; Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. 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National Institute for Health and Care Excellence (NICE)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlvim RO, Zaniqueli D, Neves FS, Pani VO, Martins CR, Pe\u0026ccedil;anha MAS, Barbosa MCR, Faria ERd, Mill JG (2019) Waist-to-height ratio is as reliable as biochemical markers to discriminate pediatric insulin resistance. Jornal de Pediatria 95(4):428\u0026ndash;434\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAguilar-Morales I, Colin-Ramirez E, Rivera-Mancia S, Vallejo M, Vazquez-Antona C (2018) Performance of Waist-To-Height Ratio, Waist Circumference, and Body Mass Index in Discriminating Cardio-Metabolic Risk Factors in a Sample of School-Aged Mexican Children. Nutrients 10(12)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaneshzad E, Rostami S, Aghamahdi F, Mahdavi-Gorabi A, Qorbani M (2022) Association of cardiometabolic risk factors with insulin resistance in overweight and obese children. 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Curr Neuropharmacol 20(5):965\u0026ndash;982\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBadamasi MI, Lye MS, Ibrahim N, Ling K-H, Stanslas J (2021) Serotonergic receptor gene polymorphism and response to selective serotonin reuptake inhibitors in ethnic Malay patients with first episode of major depressive disorder. Pharmacogenomics J. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41397-021-00228-6\u003c/span\u003e\u003cspan address=\"10.1038/s41397-021-00228-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Federal University of Health Science Azare ","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Schizophrenia, Olanzapine, Obesity, Body Mass Index (BMI), Waist-height ratio (WHtR)","lastPublishedDoi":"10.21203/rs.3.rs-4647433/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4647433/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePatients with psychotic mental disorders, including schizophrenia, often exhibit poor dietary choices and low levels of physical activity, contributing to a higher prevalence of obesity compared to the general population. This study recruited 100 patients diagnosed with schizophrenia who had been receiving Olanzapine antipsychotic medication for at least three months, alongside 100 healthy volunteers for comparison. The average age of the schizophrenia patients was 35.56\u0026thinsp;\u0026plusmn;\u0026thinsp;9.95 years, with a higher proportion of females in both groups.\u003c/p\u003e \u003cp\u003eOur findings revealed significantly higher rates of abnormal Body Mass Index (BMI) (X\u0026sup2; = 17.06, P\u0026thinsp;=\u0026thinsp;0.000036; OR\u0026thinsp;=\u0026thinsp;4.58, CI\u0026thinsp;=\u0026thinsp;2.16\u0026ndash;9.74) and abnormal waist-height ratio (WHtR) (X\u0026sup2; = 35.57, P\u0026thinsp;=\u0026thinsp;2.46E-9; OR\u0026thinsp;=\u0026thinsp;6.37, CI\u0026thinsp;=\u0026thinsp;3.39\u0026ndash;12.00) among the schizophrenia patients compared to the healthy volunteers. Notably, BMI identified 43.3% of the schizophrenia patients as having concerning weight changes, whereas WHtR identified 64.7%, indicating that WHtR is a more sensitive measure. This discrepancy means that an additional 21.4% of schizophrenia patients would benefit from weight management guidance based on WHtR rather than BMI.\u003c/p\u003e \u003cp\u003eOur results underscore the critical importance of WHtR in assessing adiposity among schizophrenia patients treated with Olanzapine, highlighting its value as a tool for monitoring and managing cardiometabolic risks in this population.\u003c/p\u003e","manuscriptTitle":"Waist-Height ratio Highlights Detrimental Risk for Olanzapine Associated Weight Gain Earlier than Body Mass Index.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-02 04:41:32","doi":"10.21203/rs.3.rs-4647433/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"627e96ed-d181-4093-981d-841458ee53c8","owner":[],"postedDate":"July 2nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":33802520,"name":"Anthropology"},{"id":33802521,"name":"Cognitive Neuroscience"}],"tags":[],"updatedAt":"2024-07-02T04:41:32+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-02 04:41:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4647433","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4647433","identity":"rs-4647433","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}