Cohen D, Dekker J J, Peen J, Gispen-de Wied C C
Psychiatric Institute Rijngeest, Noordwijkerhout, The Netherlands.
Eur Neuropsychopharmacol. 2006 Apr;16(3):187-94. doi: 10.1016/j.euroneuro.2005.09.003. Epub 2005 Nov 2.
Many reports indicate that the incidence and prevalence of diabetes mellitus is increased in schizophrenic patients and related to antipsychotic treatment. In an exploratory cross-sectional study we assessed the prevalence of type 2 diabetes mellitus in 266 chronic schizophrenic and schizoaffective inpatients and investigated whether the duration of antipsychotic treatment was related to the development of diabetes mellitus.
We measured the non-fasting plasma glucose level in 266 inpatients with DSM IV diagnosis of schizophrenia or schizoaffective disorder in 5 different long-stay wards in the Netherlands. Measured variables were: age, sex, ethnicity, BMI, current antipsychotic treatment, duration of illness and duration of antipsychotic treatment.
The overall prevalence of type 2 diabetes mellitus was 9%, which is significantly higher than the prevalence of 4.9% in the general population (OR 1.89, CI 1.14-3.13; p<0.014). The prevalence was increased in two age cohorts: 30-39 years (3.8% vs. 0.3%, OR=13.29, CI=2.17-81.36, p=<0.005) and 40-49 years (9.3% vs. 1.5%, OR=6.74, CI=2.77-16.38, p=0.000). No new cases of diabetes mellitus were detected during the course of the study. The increased prevalence was found to be related to overweight and obesity. The time of exposure to antipsychotic treatment was not significantly correlated with the prevalence of diabetes mellitus when adjusted for age (F=0.804, df=1, p=0.371, respectively, F=0.194, df=1, p=0.660). Both typical and atypical antipsychotics contributed equally to the prevalence of diabetes mellitus.
No significant relation between long-term antipsychotic treatment and prevalence of diabetes mellitus was found. The high prevalence of diabetes mellitus in schizophrenic patients warrants screening of these patients already at young age for glucose disturbance.
许多报告表明，精神分裂症患者中糖尿病的发病率和患病率有所增加，且与抗精神病药物治疗有关。在一项探索性横断面研究中，我们评估了266名慢性精神分裂症和分裂情感性障碍住院患者中2型糖尿病的患病率，并调查了抗精神病药物治疗的持续时间是否与糖尿病的发生有关。
我们在荷兰5个不同的长期住院病房中，对266名诊断为精神分裂症或分裂情感性障碍的DSM-IV住院患者测量了非空腹血糖水平。测量的变量包括：年龄、性别、种族、体重指数、当前的抗精神病药物治疗、病程和抗精神病药物治疗的持续时间。
2型糖尿病的总体患病率为9%，显著高于普通人群4.9%的患病率（OR=1.89，CI=1.14-3.13；p<0.014）。在两个年龄组中患病率有所增加：30-39岁组（3.8%对0.3%，OR=13.29，CI=2.17-81.36，p<0.005）和40-49岁组（9.3%对1.5%，OR=6.74，CI=2.77-16.38，p=0.000）。在研究过程中未发现新的糖尿病病例。发现患病率增加与超重和肥胖有关。在调整年龄后，抗精神病药物治疗的暴露时间与糖尿病患病率无显著相关性（F=0.804，自由度=1，p=0.371；F=0.194，自由度=1，p=0.660）。典型和非典型抗精神病药物对糖尿病患病率的贡献相同。
未发现长期抗精神病药物治疗与糖尿病患病率之间存在显著关系。精神分裂症患者中糖尿病的高患病率值得在这些患者年轻时就对其进行血糖紊乱筛查。
