Yumru Mehmet, Savas Haluk A, Kurt Erhan, Kaya M Cemal, Selek Salih, Savas Esen, Oral E Timucin, Atagun Ilhan
Psychiatry Department, Gaziantep University, Medical Faculty, Gaziantep, Turkey.
J Affect Disord. 2007 Mar;98(3):247-52. doi: 10.1016/j.jad.2006.08.009. Epub 2006 Sep 12.
This is the first study in bipolar patients, aimed to evaluate possible roles of the drugs, [atypical antipsychotics (AA) and mood stabilizers (MS)], inducing metabolic syndrome (MetS).
125 bipolar patients, diagnosed according to the DSM IV, were assessed cross-sectionally for MetS according to the National Cholesterol Educational Program criteria (NCEP ATP III). Patients included in the study were required to receive medications (AAs: quetiapine, risperidone and olanzapine, and MSs: Lithium, Sodium Valproate, Carbamazepine, Lamotrigine) for at least 3 months. Patients are divided into three groups as only AA users, AA+MS users and only MS users.
Of the patients, 32% were MetS, a proportion higher than normal population and similar as previous studies in bipolar patients. AA taking patients had significantly higher MetS rates than the others (chi(2)=10.47 df=2 p=0.005). Also, AA taking patients had significantly higher MetS rates than MS taking patients (chi(2)=8.86 df=1 p=0.003). There was no significant difference among quetiapine, olanzapine, risperidone usage for MetS prevalences (chi(2)=0.38 df=2 p=0.82).
AA taking bipolar patients had higher MetS rates. Despite already existing data on MetS and antipsychotics, this cross-sectional study is the first research, discusses AAs and MSs for inducing MetS in bipolar disorder. Prospectively designed researches should be conducted for further clarification of the role of these drugs in MetS.
这是第一项针对双相情感障碍患者的研究，旨在评估药物（非典型抗精神病药物和心境稳定剂）诱发代谢综合征的潜在作用。
根据《精神疾病诊断与统计手册》第四版诊断的125例双相情感障碍患者，按照美国国家胆固醇教育计划标准（NCEP ATP III）进行代谢综合征的横断面评估。纳入研究的患者需接受药物治疗（非典型抗精神病药物：喹硫平、利培酮和奥氮平，心境稳定剂：锂盐、丙戊酸钠、卡马西平、拉莫三嗪）至少3个月。患者分为三组：仅使用非典型抗精神病药物组、非典型抗精神病药物+心境稳定剂组和仅使用心境稳定剂组。
患者中32%患有代谢综合征，这一比例高于正常人群，与之前关于双相情感障碍患者的研究相似。服用非典型抗精神病药物的患者代谢综合征发生率显著高于其他患者（χ²=10.47，自由度=2，p=0.005）。此外，服用非典型抗精神病药物的患者代谢综合征发生率显著高于服用心境稳定剂的患者（χ²=8.86，自由度=1，p=0.003）。喹硫平、奥氮平、利培酮在代谢综合征患病率方面的使用情况无显著差异（χ²=0.38，自由度=2，p=0.82）。
服用非典型抗精神病药物的双相情感障碍患者代谢综合征发生率较高。尽管已有关于代谢综合征和抗精神病药物的数据，但这项横断面研究是首次探讨非典型抗精神病药物和心境稳定剂在双相情感障碍中诱发代谢综合征的研究。应进行前瞻性设计的研究，以进一步明确这些药物在代谢综合征中的作用。
