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精神分裂症中的代谢综合征:来自印度的未使用抗精神病药物/初治患者与使用抗精神病药物治疗患者的比较研究。

Metabolic syndrome in schizophrenia: a comparative study of antipsychotic-free/naïve and antipsychotic-treated patients from India.

作者信息

Pallava Abhishek, Chadda Rakesh K, Sood Mamta, Lakshmy R

机构信息

Department of Psychiatry, India Institute of Medical Sciences, New Delhi 110029, India.

出版信息

Nord J Psychiatry. 2012 Jun;66(3):215-21. doi: 10.3109/08039488.2011.621977. Epub 2011 Oct 24.

Abstract

INTRODUCTION

In recent years, metabolic syndrome (MS) has been identified as an important health risk in patients with schizophrenia and related disorders, and has often been related to the use of second-generation antipsychotics.

OBJECTIVE

The present study was conducted to assess the prevalence of MS in schizophrenia and related disorders and its correlation with various demographic, clinical and treatment variables.

METHOD

One hundred patients with schizophrenia and related disorders, 50 antipsychotic-free/naïve and 50 on antipsychotic medications for more than 3 months, attending a psychiatric outpatient setting, were assessed for various socio-demographic, clinical and metabolic parameters.

RESULTS

Subjects on treatment with antipsychotics had significantly higher mean weight, body mass index, waist circumference, calorie intake, triglycerides (TGL), very-low-density lipoproteins (VLDL), fasting blood sugar (FBS) and positive family history of diabetes mellitus compared with the antipsychotic-free/naive ones. Subjects on antipsychotics also had significantly higher prevalence of MS. A positive association of MS was observed with age, being married, higher education, executive jobs and ICD-10 diagnosis of schizophrenia, duration of illness, family history of diabetes mellitus and family history of hypertension.

CONCLUSION

Use of antipsychotics increases the risk of developing hyperlipidemia and MS in patients of schizophrenia and related disorders, emphasizing the need for regular monitoring of various metabolic parameters in patients on antipsychotics.

CLINICAL IMPLICATIONS

  1. Antipsychotics are associated with increased risk of hyperlipidemia and MS; 2) regular monitoring of lipid profile and other metabolic parameters should be done in patients on antipsychotics; 3) psychiatrists need to lay emphasis on lifestyle and dietary modifications in their patients on antipsychotics.
摘要

引言

近年来,代谢综合征(MS)已被确认为精神分裂症及相关障碍患者的一项重要健康风险,且常与第二代抗精神病药物的使用相关。

目的

本研究旨在评估精神分裂症及相关障碍患者中MS的患病率及其与各种人口统计学、临床和治疗变量的相关性。

方法

对100例精神分裂症及相关障碍患者进行评估,其中50例未服用抗精神病药物/初治患者,50例服用抗精神病药物超过3个月,这些患者均在精神科门诊就诊,评估其各种社会人口统计学、临床和代谢参数。

结果

与未服用抗精神病药物/初治患者相比,服用抗精神病药物治疗的患者平均体重、体重指数、腰围、热量摄入、甘油三酯(TGL)、极低密度脂蛋白(VLDL)、空腹血糖(FBS)及糖尿病家族史阳性率显著更高。服用抗精神病药物治疗的患者MS患病率也显著更高。MS与年龄、已婚、高等教育程度、行政工作、国际疾病分类第10版精神分裂症诊断、病程、糖尿病家族史及高血压家族史呈正相关。

结论

抗精神病药物的使用增加了精神分裂症及相关障碍患者发生高脂血症和MS的风险,强调了对服用抗精神病药物患者定期监测各种代谢参数的必要性。

临床意义

1)抗精神病药物与高脂血症和MS风险增加相关;2)应对服用抗精神病药物的患者定期监测血脂谱及其他代谢参数;3)精神科医生需要重视对服用抗精神病药物患者的生活方式及饮食调整。

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