Hammerman Ariel, Dreiher Jacob, Klang Shmuel H, Munitz Hanan, Cohen Arnon D, Goldfracht Margalit
Department of Pharmacy and Pharmacology, Clalit Health Services, Tel-Aviv, Israel.
Ann Pharmacother. 2008 Sep;42(9):1316-22. doi: 10.1345/aph.1L015. Epub 2008 Jul 29.
Previous studies have reported an association between anti-psychotic medications and diabetes.
To explore the association between antipsychotic medications and diabetes in patients of different ages.
A retrospective analysis of a large health maintenance organization's drug claim database (3.7 million members) was performed. All patients treated with antipsychotic drugs during 1998-2004 were identified. Patients with diabetes were defined by a record of antidiabetic drug use during 2004. The prevalence of diabetes in different age groups treated with antipsychotics was compared with the prevalence of diabetes among enrollees in the same age groups not treated with antipsychotics.
Among 82,754 patients treated with antipsychotics, the association between diabetes and consumption of antipsychotics was strongest in the younger age groups and decreased with increasing age: for patients aged 0-24 years, OR 8.9 (95% CI 7.0 to 11.3); 25-44 years, OR 4.2 (95% CI 3.8 to 4.5); 45-54 years, OR 1.9 (95% CI 1.8 to 2.1); 55-64 years, OR 1.3 (95% CI 1.2 to 1.4); and 65 years or older, OR 0.93 (95% CI 0.9 to 1.0). However, the risk associated with atypical antipsychotics was lower than the risk associated with typical antipsychotics, with ORs ranging from 0.7 in patients 0-24 years old to 0.3 in those 65 years or older.
Antipsychotic drug use was associated with diabetes mellitus. This association was stronger in younger patients. In older adults, the difference was much smaller and, in some cases, there was no association. A lower risk was associated with atypical agents, as compared with typical antipsychotics. Clinicians should be aware that young adults treated with antipsychotics are at increased risk for diabetes.
既往研究报道了抗精神病药物与糖尿病之间的关联。
探讨不同年龄患者中抗精神病药物与糖尿病之间的关联。
对一个大型健康维护组织的药物索赔数据库（370万成员）进行回顾性分析。确定了1998年至2004年期间所有接受抗精神病药物治疗的患者。糖尿病患者通过2004年期间使用抗糖尿病药物的记录来定义。将接受抗精神病药物治疗的不同年龄组的糖尿病患病率与未接受抗精神病药物治疗的同年龄组登记参与者中的糖尿病患病率进行比较。
在82754例接受抗精神病药物治疗的患者中，糖尿病与抗精神病药物使用之间的关联在较年轻年龄组中最强，且随年龄增长而降低：0至24岁患者，比值比（OR）为8.9（95%置信区间[CI]为7.0至11.3）；25至44岁患者，OR为4.2（95%CI为3.8至4.5）；45至54岁患者，OR为1.9（95%CI为1.8至2.1）；55至64岁患者，OR为1.3（95%CI为1.2至1.4）；65岁及以上患者，OR为0.93（95%CI为0.9至1.0）。然而，与非典型抗精神病药物相关的风险低于与典型抗精神病药物相关的风险，OR范围从0至24岁患者中的0.7到65岁及以上患者中的0.3。
使用抗精神病药物与糖尿病有关。这种关联在年轻患者中更强。在老年人中，差异要小得多，在某些情况下，没有关联。与典型抗精神病药物相比，非典型药物相关风险较低。临床医生应意识到接受抗精神病药物治疗的年轻人患糖尿病的风险增加。
