Basu Ranita, Brar Jaspreet S, Chengappa K N Roy, John Vineeth, Parepally Haranath, Gershon Samuel, Schlicht Patricia, Kupfer David J
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213-2593, USA.
Bipolar Disord. 2004 Aug;6(4):314-8. doi: 10.1111/j.1399-5618.2004.00126.x.
To evaluate the point prevalence of the metabolic syndrome in patients with schizoaffective disorder--bipolar type.
Consenting patients who were participants in an ongoing clinical trial of adjunctive topiramate treatment for schizoaffective disorder, bipolar type were evaluated at baseline for the point prevalence of the metabolic syndrome. The criteria for the metabolic syndrome included: (a) waist circumference > 102 cm (40 inches) in males, or > 88 cm (35 inches) in females; (b) fasting serum triglyceride levels > or = 150 mg/dL; (c) fasting high density lipoproteins (HDL) cholesterol <40 mg/dL in men or <50 mg/dL in women; (d) blood pressure > or = 130/85 mmHg; and (e) fasting glucose > or = 110 mg/dL. Subjects who had at least three of these five criteria were defined as meeting criteria for the metabolic syndrome.
Thirty-six subjects (males = 15, females = 21) were evaluated, and three were excluded for missing data. Among those 33 subjects with complete data, 14 subjects (42.4%, males = 7, females = 7, African Americans = 6, Caucasians = 8) met criteria for the metabolic syndrome. Not unexpectedly, those with the metabolic syndrome were significantly more likely to be obese, and have significantly higher mean systolic and diastolic blood pressure, mean fasting triglyceride levels and larger mean waist circumferences, and significantly lower HDL cholesterol levels; and a trend toward higher fasting blood glucose levels. Furthermore, the fasting mean total cholesterol in those with the metabolic syndrome was 217 mg/dL (+/-46).
This preliminary report suggests that the point prevalence of the metabolic syndrome in patients with schizoaffective disorder appears to be higher than that reported in the general population of the USA. Targeted weight reduction and life style change strategies (increased exercise, smoking cessation, stress reduction) may provide useful interventions to decrease the morbidity and mortality that accompanies the presence of the metabolic syndrome in patients with psychiatric illnesses.
评估双相型分裂情感性障碍患者代谢综合征的时点患病率。
正在参与一项双相型分裂情感性障碍辅助托吡酯治疗临床试验的同意参与的患者，在基线时对代谢综合征的时点患病率进行评估。代谢综合征的标准包括：（a）男性腰围>102厘米（40英寸），女性腰围>88厘米（35英寸）；（b）空腹血清甘油三酯水平≥150毫克/分升；（c）男性空腹高密度脂蛋白（HDL）胆固醇<40毫克/分升，女性<50毫克/分升；（d）血压≥130/85毫米汞柱；（e）空腹血糖≥110毫克/分升。满足这五项标准中至少三项的受试者被定义为符合代谢综合征标准。
对36名受试者（男性15名，女性21名）进行了评估，3名因数据缺失被排除。在这33名有完整数据的受试者中，14名受试者（42.4%，男性7名，女性7名，非裔美国人6名，白种人8名）符合代谢综合征标准。不出所料，患有代谢综合征的患者明显更易肥胖，平均收缩压和舒张压、平均空腹甘油三酯水平显著更高，平均腰围更大，高密度脂蛋白胆固醇水平显著更低；空腹血糖水平有升高趋势。此外，患有代谢综合征的患者空腹平均总胆固醇为217毫克/分升（±46）。
这份初步报告表明，分裂情感性障碍患者代谢综合征的时点患病率似乎高于美国普通人群的报告患病率。有针对性的减重和生活方式改变策略（增加运动、戒烟、减轻压力）可能为降低精神疾病患者代谢综合征相关的发病率和死亡率提供有益干预措施。
