Holt Richard I G, Bushe Chris, Citrome Leslie
Developmental Origins of Health and Disease Division, University of Southampton, Southampton, UK.
J Psychopharmacol. 2005 Nov;19(6 Suppl):56-65. doi: 10.1177/0269881105058379.
The association between schizophrenia and diabetes has been recognized for well over a century, but the underlying reasons for this association are unclear. In October 2003, an international group of diabetologists and psychiatrists met to review the literature relating to the association, and to create pragmatic guidelines for the management of diabetic risk in patients with severe mental illness. Since that meeting, over 100 additional papers have been published on the association between glucose abnormalities and schizophrenia, and this is a clear reflection of the level of interest in this clinically important area. Diabetes is highly prevalent among the schizophrenia population, but most sufferers remain undiagnosed in the community. The reasons why individuals with schizophrenia are more prone to developing diabetes than the general population are poorly defined, but likely to be multifactorial. The role of antipsychotic medications in the development of diabetes and other pre-diabetic states remains controversial, but it appears that the attributable risk is low. Traditional risk factors most probably account for much of the diabetes seen in schizophrenia populations, suggesting that routine screening and aggressive risk factor management are especially important in this patient group.
精神分裂症与糖尿病之间的关联已被认识超过一个世纪，但这种关联的潜在原因尚不清楚。2003年10月，一群国际糖尿病专家和精神科医生齐聚一堂，回顾了与该关联相关的文献，并为严重精神疾病患者的糖尿病风险管理制定实用指南。自那次会议以来，又有100多篇关于血糖异常与精神分裂症之间关联的论文发表，这清楚地反映了人们对这一临床重要领域的关注程度。糖尿病在精神分裂症患者群体中非常普遍，但大多数患者在社区中仍未被诊断出来。精神分裂症患者比普通人群更容易患糖尿病的原因尚不明确，但可能是多因素的。抗精神病药物在糖尿病及其他糖尿病前期状态发生中的作用仍存在争议，但似乎归因风险较低。传统风险因素很可能是精神分裂症患者群体中糖尿病的主要原因，这表明常规筛查和积极的风险因素管理在该患者群体中尤为重要。
