Gupta Sanjay, Steinmeyer Charles, Frank Bradford, Madhusoodanan S, Lockwood Kari, Lentz Barbara, Keller Peggy
Department of Psychiatry, Olean General Hospital, Olean, NY 14760, USA.
Am J Ther. 2003 Sep-Oct;10(5):348-55. doi: 10.1097/00045391-200309000-00007.
There have been recent reports in the psychiatric literature of the possible association of glucose dysregulation and diabetes mellitus with the use of atypical antipsychotics. This article describes a retrospective chart review of patients from various clinical settings, including a continuing day treatment program, two inpatient programs, and a large private practice. Information was obtained with regard to weight, fasting blood glucose, lipid profiles, EKG changes, and medical comorbidities. The patients included those treated with conventional antipsychotic agents, clozapine, risperidone, olanzapine, and quetiapine. No one antipsychotic agent was associated with a statistically significantly higher prevalence of diabetes, lipid abnormalities, or EKG problems. It was noted, however, that there were higher rates of diabetes (17%), lipid abnormalities (43%), and hypertension (30%) across the sample. This finding suggests that the high prevalence of diabetes, lipid abnormalities, and hypertension in a young, chronically psychiatrically ill population makes the case for aggressive screening.
近期精神病学文献中有报道称，使用非典型抗精神病药物可能与血糖调节异常及糖尿病有关。本文描述了对来自各种临床环境的患者进行的回顾性病历审查，这些临床环境包括一个日间持续治疗项目、两个住院治疗项目以及一个大型私人诊所。收集了有关体重、空腹血糖、血脂谱、心电图变化和合并症的信息。患者包括接受传统抗精神病药物、氯氮平、利培酮、奥氮平和喹硫平治疗的患者。没有一种抗精神病药物与糖尿病、血脂异常或心电图问题的患病率在统计学上显著更高相关。然而，值得注意的是，整个样本中糖尿病（17%）、血脂异常（43%）和高血压（30%）的发生率较高。这一发现表明，在年轻的慢性精神病患者人群中，糖尿病、血脂异常和高血压的高患病率使得积极筛查成为必要。
