Schultz S K, Arndt S, Ho B C, Oliver S E, Andreasen N C
Department of Psychiatry, University of Iowa College of Medicine, Iowa City, USA.
Am J Psychiatry. 1999 Apr;156(4):640-2. doi: 10.1176/ajp.156.4.640.
Diabetes mellitus has been implicated as a risk factor for tardive dyskinesia. The authors examined the association between abnormal movements and impaired glucose metabolism, which often precedes the development of overt diabetes, in patients with schizophrenia.
Twenty-one patients with DSM-IV schizophrenia receiving neuroleptic medication were given oral glucose tolerance tests involving serial glucose and insulin levels. These values were analyzed in relationship to abnormal involuntary movement ratings.
Patients with impaired glucose tolerance had higher mean abnormal movement scores than those without glucose intolerance, but this difference was not statistically significant. There was, however, an association between the magnitude of the fasting insulin level and abnormal movements after the authors controlled for fasting glucose level. Additionally, the fasting glucose level predicted abnormal movements after the authors controlled for age.
Hyperinsulinemia and hyperglycemia associated with insulin resistance may potentially contribute to the pathogenesis of tardive dyskinesia. Findings from this small cross-sectional study suggest a possible relationship that requires clarification through larger, longitudinal studies.
糖尿病已被认为是迟发性运动障碍的一个风险因素。作者研究了精神分裂症患者中异常运动与葡萄糖代谢受损（这通常先于显性糖尿病的发生）之间的关联。
对21例接受抗精神病药物治疗的DSM-IV精神分裂症患者进行口服葡萄糖耐量试验，检测系列血糖和胰岛素水平。分析这些值与异常不自主运动评分之间的关系。
糖耐量受损患者的平均异常运动评分高于糖耐量正常者，但差异无统计学意义。然而，在作者控制空腹血糖水平后，空腹胰岛素水平的幅度与异常运动之间存在关联。此外，在作者控制年龄后，空腹血糖水平可预测异常运动。
与胰岛素抵抗相关的高胰岛素血症和高血糖可能潜在地促成迟发性运动障碍的发病机制。这项小型横断面研究的结果提示了一种可能的关系，需要通过更大规模的纵向研究加以阐明。
