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台湾地区双相障碍患者代谢紊乱的高发率。

High prevalence of metabolic disturbances in patients with bipolar disorder in Taiwan.

机构信息

Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

J Affect Disord. 2009 Sep;117(1-2):124-9. doi: 10.1016/j.jad.2008.12.018. Epub 2009 Feb 4.

Abstract

BACKGROUND

Both ethnicity and lifestyle may contribute to these abnormalities. High prevalences of obesity and metabolic disturbances in patients with bipolar disorder (BD) have been reported in western countries. However, reports about the prevalences in Asian countries remain scant.

METHOD

The cross-sectional study included 117 patients diagnosed as BD and treated with lithium (Li), valproate (VPA), or both at a university psychiatric outpatient clinic. Their body mass index and plasma levels of glucose and lipid were measured. The prevalence of metabolic syndrome was determined based on the IDF 2005 criteria.

RESULTS

13.7%, 36.8%, 53.0%, 18.6%, and 61.0% of the patients met the criteria for hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), hypertension and large waist circumference, respectively. 33.9% of the patients met the IDF 2005 criterion for metabolic syndrome. The prevalence of metabolic abnormalities was significantly higher in patients who have been cotreated with second-generation antipsychotics (SGAs).

CONCLUSION

This study provides evidence of high prevalence of metabolic syndrome in BD patients in Taiwan. Such metabolic disturbances can increase morbidity and mortality. Further studies that focus on the underlying mechanisms and effective intervention strategies are warranted.

摘要

背景

种族和生活方式都可能导致这些异常。在西方国家,双相情感障碍(BD)患者中肥胖和代谢紊乱的患病率很高。然而,关于亚洲国家的患病率的报告仍然很少。

方法

这项横断面研究纳入了在一所大学精神病门诊接受锂(Li)、丙戊酸(VPA)或两者联合治疗的 117 名 BD 患者。测量了他们的体重指数和血糖及血脂水平。根据 IDF 2005 标准确定代谢综合征的患病率。

结果

分别有 13.7%、36.8%、53.0%、18.6%和 61.0%的患者符合高血糖、高三酰甘油血症、低高密度脂蛋白胆固醇(HDL-C)、高血压和大腰围的标准。33.9%的患者符合 IDF 2005 代谢综合征标准。与仅接受第一代抗精神病药物(FGAs)治疗的患者相比,联合使用第二代抗精神病药物(SGAs)的患者发生代谢异常的比例显著更高。

结论

本研究为台湾 BD 患者代谢综合征高发提供了证据。这些代谢紊乱会增加发病率和死亡率。需要进一步研究其潜在机制和有效的干预策略。

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