Wu Ren-Rong, Zhao Jing-Ping, Liu Zhe-Ning, Zhai Jin-Guo, Guo Xiao-Feng, Guo Wen-Bing, Tang Jing-Song
Institute of Mental Health of The Second Xiangya Hospital, Central South University, #139 Renmin Middle Road, Changsha, Hunan, 410011, China.
Psychopharmacology (Berl). 2006 Jul;186(4):572-8. doi: 10.1007/s00213-006-0384-5. Epub 2006 Apr 7.
Glucose and lipid metabolism dysfunction is a significant side effect associated with antipsychotics. Although there are many studies about the linkages between drugs and metabolic dysfunction, most of these studies have compared the effects of two antipsychotics on only one metabolic measure: either glucose or lipid metabolism.
The present study aimed to investigate the effects of clozapine, olanzapine, risperidone, and sulpiride on glucose and lipid metabolism in first-episode schizophrenia.
One hundred twelve schizophrenics were assigned randomly to receive clozapine, olanzapine, risperidone, or sulpiride for 8 weeks. Planned assessments included body mass index (BMI), waist-to-hip ratio, fasting glucose, insulin, C-peptide, insulin resistance index (IRI), cholesterol, and triglyceride. All measures were collected at baseline and at the end of the 8-week treatment.
After treatment, insulin, C-peptide, and IRI were significantly increased in the four groups, but not fasting glucose levels. Cholesterol and triglyceride levels were significantly increased in the clozapine and olanzapine groups. Patients treated with clozapine and olanzapine had higher fasting insulin, C-peptide, and IRI levels than those treated with risperidone and sulpiride. Among the four antipsychotics, the increases of mean BMI from high to low were as follows: clozapine, olanzapine, sulpiride, and risperidone.
This study confirmed that the four antipsychotic drugs were associated with an increase of insulin, C-peptide, and IRI. It was found that clozapine and olanzapine were associated with an increase in cholesterol and triglyceride levels. The effects of clozapine and olanzapine on the glucose and lipid metabolism outweighed those of risperidone and sulpiride.
葡萄糖和脂质代谢功能障碍是抗精神病药物的一种显著副作用。尽管有许多关于药物与代谢功能障碍之间联系的研究，但这些研究大多仅比较了两种抗精神病药物对单一代谢指标（即葡萄糖或脂质代谢）的影响。
本研究旨在调查氯氮平、奥氮平、利培酮和舒必利对首发精神分裂症患者葡萄糖和脂质代谢的影响。
112名精神分裂症患者被随机分配接受氯氮平、奥氮平、利培酮或舒必利治疗8周。计划评估指标包括体重指数（BMI）、腰臀比、空腹血糖、胰岛素、C肽、胰岛素抵抗指数（IRI）、胆固醇和甘油三酯。所有指标均在基线时及8周治疗结束时收集。
治疗后，四组患者的胰岛素、C肽和IRI均显著升高，但空腹血糖水平未升高。氯氮平和奥氮平组的胆固醇和甘油三酯水平显著升高。接受氯氮平和奥氮平治疗的患者空腹胰岛素、C肽和IRI水平高于接受利培酮和舒必利治疗的患者。在这四种抗精神病药物中，平均BMI升高幅度从高到低依次为：氯氮平、奥氮平、舒必利、利培酮。
本研究证实这四种抗精神病药物与胰岛素、C肽和IRI升高有关。发现氯氮平和奥氮平与胆固醇和甘油三酯水平升高有关。氯氮平和奥氮平对葡萄糖和脂质代谢的影响大于利培酮和舒必利。
