Bai Ya Mei, Chen Tzu Ting, Yang Wei-Shiung, Chi Yu-Chao, Lin Chao-Cheng, Liou Ying-Jay, Wang Ying-Chieh, Su Tung-Ping, Chou Pesus, Chen Jen-Yeu
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Schizophr Res. 2009 Jun;111(1-3):1-8. doi: 10.1016/j.schres.2009.03.014. Epub 2009 May 5.
Adiponectin, an adipocyte-derived hormone controlling lipid and carbohydrate metabolism, has been suggested to be a biomarker for metabolic syndrome in the general population. This study investigated the association between adiponectin levels and metabolic syndrome in patients treated with atypical antipsychotics.
Anthropometric and metabolic parameters and serum adiponectin levels were assessed in hospitalized patients with schizophrenia who had used the same atypical antipsychotic for at least 3 months. Retrospective reviews of the patients' medical records were conducted to obtain demographic data and pretreatment characteristics.
The study included 567 schizophrenia patients treated with clozapine (n=231), olanzapine (n=94) and risperidone (n=242), for an average of 45.8+/-27.8 months. The prevalence of metabolic syndrome among all subjects was 23.8%. The clozapine group had a higher prevalence of metabolic syndrome (28.7%) than did the olanzapine (24.2%) and risperidone groups (19.5%) (P=0.039), and the clozapine group had lower levels of adiponectin (8.46+/-6.02 mg/mL) than did the olanzapine (10.26+/-4. 9 mg/mL) and risperidone groups (10.69+/-7.43 mg/mL) (P=0.001). Adiponectin level was negatively correlated with body mass index (BMI) increase after initiation of antipsychotic treatment. Cross-sectional regression analysis showed that age (OR,=1.042, P=0.001), BMI (OR=1.404, P<0.0001), and adiponectin level (OR=0.862, P<0.0001) were significant factors in the presence of metabolic syndrome. Significant predictors of metabolic syndrome were age at initiation of antipsychotic treatment (OR=1.04, P=.007), BMI at initiation of antipsychotic treatment (OR=1.44, P<0.0001), BMI increase after initiation of antipsychotic treatment (OR=1.40, P<0.0001), and adiponectin level (OR=0.86, P<0.0001).
Lower levels of adiponectin and weight gain after taking antipsychotics are associated with higher risk of metabolic syndrome in patients taking atypical antipsychotics.
脂联素是一种由脂肪细胞分泌的、调控脂质和碳水化合物代谢的激素，被认为是普通人群代谢综合征的生物标志物。本研究调查了使用非典型抗精神病药物治疗的患者中脂联素水平与代谢综合征之间的关联。
对使用同一种非典型抗精神病药物至少3个月的住院精神分裂症患者进行人体测量和代谢参数评估以及血清脂联素水平检测。回顾性查阅患者病历以获取人口统计学数据和治疗前特征。
该研究纳入了567例使用氯氮平（n = 231）、奥氮平（n = 94）和利培酮（n = 242）治疗的精神分裂症患者，平均治疗时间为45.8±27.8个月。所有受试者中代谢综合征的患病率为23.8%。氯氮平组代谢综合征的患病率（28.7%）高于奥氮平组（24.2%）和利培酮组（19.5%）（P = 0.039），且氯氮平组的脂联素水平（8.46±6.02mg/mL）低于奥氮平组（10.26±4.9mg/mL）和利培酮组（10.69±7.43mg/mL）（P = 0.001）。抗精神病药物治疗开始后脂联素水平与体重指数（BMI）的增加呈负相关。横断面回归分析显示，年龄（OR = 1.042，P = 0.001）、BMI（OR = 1.404，P < 0.0001）和脂联素水平（OR = 0.862，P < 0.0001）是代谢综合征存在的显著因素。代谢综合征的显著预测因素为抗精神病药物治疗开始时的年龄（OR = 1.04，P = 0.007）、抗精神病药物治疗开始时的BMI（OR = 1.44，P < 0.0001）、抗精神病药物治疗开始后BMI的增加（OR = 1.40，P < 0.0001）和脂联素水平（OR = 0.86，P < 0.0001）。
服用非典型抗精神病药物的患者中，脂联素水平较低以及服用抗精神病药物后体重增加与代谢综合征的较高风险相关。
