Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Schizophr Res. 2010 Dec;124(1-3):49-53. doi: 10.1016/j.schres.2010.09.013. Epub 2010 Oct 13.
A unique group of individuals termed metabolically obese but normal weight (MONW) has been identified in the general population. The present study examined phenotypic characteristics of MONW individuals in a sample of normal weight, non-diabetic patients with schizophrenia.
Outpatients 19 to 75 years old diagnosed with schizophrenia or schizoaffective disorder participated in a multi-center, cross-sectional study. Those with normal weight (body-mass-index (BMI)<25 kg/m(2)) were included in the present analysis. Patients were further defined as MONW or metabolically nonobese based on a cut-off value of the homeostasis model assessment of insulin resistance (HOMA-IR = 1.86). Fasting blood samples were collected to determine levels of various metabolic parameters. In addition, lipoprotein subclass concentrations and sizes were analyzed using nuclear magnetic resonance (NMR) spectroscopy.
Seventeen MONW individuals and 17 metabolically nonobese individuals matched by BMI and gender were identified from a study sample of 206 patients with schizophrenia. There were no significant differences between the two groups on anthropometric measures (waist circumference and waist/hip ratio, ps>0.3). However, the MONW group had significantly higher levels of intermediate VLDL particle and Apolipoprotein B, and significantly lower levels of large HDL particle compared with the metabolically nonobese group (p = 0.012, p = 0.036 and p = 0.041 respectively).
The MONW individuals in non-diabetic schizophrenia patients seem to have an unfavorable metabolic profile and significant atherogenecity. Clinicians should be vigilant about the risk of cardiometabolic comorbidity even when the patient' body weight is normal.
在普通人群中已经确定了一个被称为代谢肥胖但体重正常(MONW)的独特人群。本研究在一组正常体重、非糖尿病精神分裂症患者的样本中检查了 MONW 个体的表型特征。
19 至 75 岁被诊断患有精神分裂症或分裂情感障碍的门诊患者参加了一项多中心、横断面研究。本分析纳入了体重正常(体重指数(BMI)<25kg/m2)的患者。根据胰岛素抵抗的稳态模型评估(HOMA-IR=1.86)的截断值,患者进一步被定义为 MONW 或代谢非肥胖。采集空腹血样以确定各种代谢参数的水平。此外,使用核磁共振(NMR)光谱法分析脂蛋白亚类浓度和大小。
从 206 例精神分裂症患者的研究样本中确定了 17 名 MONW 个体和 17 名按 BMI 和性别匹配的代谢非肥胖个体。两组在人体测量指标(腰围和腰臀比,ps>0.3)上无显著差异。然而,与代谢非肥胖组相比,MONW 组的中间 VLDL 颗粒和载脂蛋白 B 水平显著升高,大 HDL 颗粒水平显著降低(p=0.012,p=0.036 和 p=0.041 分别)。
非糖尿病精神分裂症患者中的 MONW 个体似乎具有不利的代谢特征和明显的动脉粥样硬化性。即使患者的体重正常,临床医生也应该警惕心血管代谢合并症的风险。