Hennings J M, Ising M, Grautoff S, Himmerich H, Pollmächer T, Schaaf L
Max Planck Institute of Psychiatry, 80804 Munich, Germany.
Exp Clin Endocrinol Diabetes. 2010 Feb;118(2):98-100. doi: 10.1055/s-0029-1237361. Epub 2009 Oct 15.
Impaired glucose tolerance and diabetes have been associated with depression, and antidepressant treatment is assumed to improve impaired glucose tolerance. However, antidepressant treatment is also considered as a risk factor for the development of diabetes. Reports about glucose tolerance under antidepressant treatment frequently lack appropriate control groups. We conducted the oral glucose tolerance test (OGTT) in 10 healthy controls selected from an epidemiological sample with a negative lifetime history of mental Axis I disorder. Controls were carefully matched to a sample of inpatients with major depression that participated in an OGTT before and after antidepressant treatment with mirtazapine. All participants underwent a standard OGTT protocol. In patients, a second (after 2 weeks) and a third (after 4-6 weeks) OGTT was performed under treatment with mirtazapine. Compared to healthy controls, we observed significantly impaired glucose tolerance in acutely depressed patients. Effect size calculation indicated a moderate to large effects on glucose and insulin concentrations in response to an OGTT. Although glucose tolerance improved under mirtazapine treatment, insulin sensitivity was still impaired and remained significantly lower in patients compared to controls.
糖耐量受损和糖尿病与抑郁症有关，并且抗抑郁治疗被认为可改善糖耐量受损。然而，抗抑郁治疗也被视为糖尿病发生的一个危险因素。关于抗抑郁治疗下糖耐量的报告常常缺乏适当的对照组。我们对从一个终生精神轴I障碍病史为阴性的流行病学样本中选取的10名健康对照者进行了口服葡萄糖耐量试验（OGTT）。对照者与一组在接受米氮平抗抑郁治疗前后均进行了OGTT的重度抑郁症住院患者样本进行了仔细匹配。所有参与者都接受了标准的OGTT方案。在患者中，在接受米氮平治疗期间进行了第二次（2周后）和第三次（4 - 6周后）OGTT。与健康对照者相比，我们观察到急性抑郁患者的糖耐量显著受损。效应量计算表明，对OGTT反应的葡萄糖和胰岛素浓度有中度到较大的影响效应。尽管在米氮平治疗下糖耐量有所改善，但胰岛素敏感性仍然受损，并且患者与对照者相比仍显著较低。
