Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
Prog Neuropsychopharmacol Biol Psychiatry. 2011 Mar 30;35(2):490-6. doi: 10.1016/j.pnpbp.2010.12.003. Epub 2010 Dec 10.
The objective of this study was to evaluate weight gain and its potential risk factors among different second generation antipsychotics (SGAs). The study was conducted for Korean inpatients with schizophrenia in a university hospital in Seoul, between Jan 2000 and Dec 2007. Data were collected by reviewing the medical records of the patients, who were prescribed to one of the SGAs among aripiprazole, olanzapine, quetiapine or risperidone. The changes of weight and body mass index (BMI); risk of clinically significant weight gain (>7% gain to initial weight) and their associations with various clinical characteristics of such patients were analyzed. Five hundred and eighty-eight (588) and 294 subjects treated with one of the four SGAs for a duration of 1 month and 2 months were included, respectively. Olanzapine showed significantly greater weight and BMI increase at month 1 (p=0.028 for weight; p=0.019 for BMI) and month 2 (p=0.032 for weight; p=0.029 for BMI) than others. Females showed greater BMI increase change (0.70±0.91 kg/m(2), p=0.008) and were also more likely to experience clinically significant weight gain (odd ratio=1.846, 95% CI=1.098 to 3.105, p=0.021) at month 1. Younger patients (<45 years old) had significantly greater weight and BMI increase at both months 1 and 2. Younger patients also showed greater risk for clinically significant weight gain at month 2 (odd odd ratio=2.567, 95% CI=1.196 to 5.508, p=0.016). Low baseline BMI (<25 kg/m(2)) was associated with greater weight gain at month 1 (1.92±2.29 kg, p<0.001) and month 2 (4.07±3.56 kg, p<0.001) and BMI increase at month 1 and month 2 (p<0.001 for both). Patients with low baseline BMI showed higher risk of clinically significant weight gain at both months 1 and 2 (p<0.001 for both). Olanzapine was shown to have higher metabolic risk than other SGAs in inpatients with schizophrenia. The individual's own clinical characteristics also exerted influence on weight gain effects of SGAs. Younger patients with lower baseline BMI were under greater risk of antipsychotic-induced weight gain. More studies are required to verify the role of gender on weight gain.
本研究旨在评估不同第二代抗精神病药物（SGAs）的体重增加及其潜在风险因素。该研究在首尔一所大学附属医院对韩国住院精神分裂症患者进行，时间为 2000 年 1 月至 2007 年 12 月。通过回顾患者的病历收集数据，这些患者被开处方使用阿立哌唑、奥氮平、喹硫平或利培酮中的一种 SGA。分析了体重和体重指数（BMI）的变化；体重显著增加（增加初始体重的 7%以上）的风险及其与这些患者的各种临床特征之间的关联。分别纳入 588 名（588 名）和 294 名接受四种 SGA 之一治疗 1 个月和 2 个月的患者。奥氮平在第 1 个月（体重 p=0.028；BMI p=0.019）和第 2 个月（体重 p=0.032；BMI p=0.029）时体重和 BMI 增加显著更大。女性 BMI 增加变化更大（0.70±0.91kg/m2，p=0.008），在第 1 个月也更有可能出现临床显著的体重增加（优势比=1.846，95%置信区间=1.098 至 3.105，p=0.021）。年龄较小的患者（<45 岁）在第 1 个月和第 2 个月体重和 BMI 增加均显著更大。年龄较小的患者在第 2 个月也表现出更大的临床显著体重增加风险（优势比=2.567，95%置信区间=1.196 至 5.508，p=0.016）。较低的基线 BMI（<25kg/m2）与第 1 个月（1.92±2.29kg，p<0.001）和第 2 个月（4.07±3.56kg，p<0.001）以及第 1 个月和第 2 个月的 BMI 增加有关（均 p<0.001）。基线 BMI 较低的患者在第 1 个月和第 2 个月均存在更高的临床显著体重增加风险（均 p<0.001）。奥氮平在精神分裂症住院患者中比其他 SGA 具有更高的代谢风险。个体自身的临床特征也对 SGA 的体重增加效应产生影响。年龄较小且基线 BMI 较低的患者面临更大的抗精神病药引起的体重增加风险。需要更多的研究来验证性别对体重增加的作用。
