Sitburana Oraporn, Rountree Susan, Ondo William G
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
J Neurol Sci. 2008 Sep 15;272(1-2):77-82. doi: 10.1016/j.jns.2008.04.026. Epub 2008 Jun 16.
Atypical antipsychotics (AA) are generally associated with weight gain. We determined body mass index (BMI) change in Parkinson's disease (PD) before and after taking AA and compared against PD controls and Alzheimer's disease (AD) patients on AA. In 66 consecutive PD subjects started on AA who had accurate weights for more than 6 months before and after initiation of AA, we compared weight change before and after AA use, against a control group of sixty-one sex-matched PD subjects, and against twenty-eight AD subjects taking AA. A linear regression model was created to compare weight changes. Fifty-nine PD subjects had complete data, quetiapine (n=53) and clozapine (n=6). The mean BMI change in the period before starting AA was 0.00 kg/m(2)/month over 1.95+/-1.41 years. After starting AA, subjects lost 0.03 kg/m(2)/month (95% CI 0.62-1.21, P<0.0001), comparing PD before AA to the same PD patients after AA. In 61 PD controls, the mean BMI loss was 0.01 kg/m(2)/month (95% CI 0.15-0.94, P=0.007) comparing PD on AA vs. PD controls. The BMI for 28 AD subjects on AA increased 0.01 kg/m(2)/month (95% CI 0.26-0.83, P<0.0001), comparing PD on AA vs. AD on AA. The weight loss seen in the PD/AA group, compared to AD, suggest uniquely altered weight homeostasis in PD.
非典型抗精神病药物(AA)通常与体重增加有关。我们测定了帕金森病(PD)患者服用AA前后的体重指数(BMI)变化,并与未服用AA的PD对照组以及服用AA的阿尔茨海默病(AD)患者进行比较。在66例连续开始服用AA的PD受试者中,这些受试者在开始服用AA前后均有超过6个月的准确体重记录,我们将服用AA前后的体重变化与61例性别匹配的PD受试者对照组以及28例服用AA的AD受试者进行比较。建立线性回归模型以比较体重变化。59例PD受试者有完整数据,其中服用喹硫平的有53例,服用氯氮平的有6例。在开始服用AA前的1.95±1.41年期间,BMI的平均变化为0.00 kg/m²/月。开始服用AA后,将服用AA前的PD患者与服用AA后的同一批PD患者相比,受试者体重每月减轻0.03 kg/m²(95%可信区间0.62 - 1.21,P<0.0001)。在61例PD对照组中,将服用AA的PD患者与PD对照组相比,BMI平均每月下降0.01 kg/m²(95%可信区间0.15 - 0.94,P = 0.007)。将服用AA的PD患者与服用AA的AD患者相比,28例服用AA的AD受试者的BMI每月增加0.01 kg/m²(95%可信区间0.26 - 0.83,P<0.0001)。与AD相比,PD/AA组出现的体重减轻表明PD患者的体重稳态发生了独特改变。