Kesim Murat, Tiryaki Ahmet, Kadioglu Mine, Muci Efnan, Kalyoncu Nuri Ihsan, Yaris Ersin
Associate Professor, Department of Pharmacology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
J Res Med Sci. 2011 Dec;16(12):1525-31.
In this study, we aimed to investigate the possible effects of sertraline on blood glucose and lipid levels as risk factors for cardiovascular disease in depressive patients.
Eight male and twelve female depressive patients, diagnosed according to DSM-IV criteria, were included in this study. The subjects aged 19-50 years, did not smoke, and had normal body mass index (BMI), homeostasis model assessment-estimated insulin resistance (HOMA-IR) values, blood pressure, blood glucose, insulin and lipid levels. Sertraline therapy (50 mg/day) was started. Patients with diabetes mellitus, heart disease, pregnancy, and those taking other drugs were excluded from the study. Blood glucose, insulin, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglyceride values were measured in patients before, and at the 4(th), 8(th) and 12(th) weeks after treatment with sertraline. Moreover, HbA1C levels were measured at the beginning and at the end of the treatment (at 12(th) weeks).
There were no significant differences in physical examination (blood pressure, BMI, body weight, height, waist circumference) and laboratory findings (glucose, HDL-C, LDL-C, HOMA-IR and HbA1C levels) at the 12(th) week after of treatment with sertraline compared to pretreatment values. However, insulin levels at the 4(th), 8(th) and 12(th) weeks significantly increased compared with pretreatment values. Likewise, triglyceride levels at the 8(th) and 12(th) weeks significantly increased compared with pretreatment values.
Sertraline-treated patients have to be followed up for blood insulin and triglyceride levels. In addition, their treatment plan needs to be adjusted as necessary to prevent possible metabolic changes.
在本研究中，我们旨在调查舍曲林对抑郁症患者血糖和血脂水平的可能影响，这些指标是心血管疾病的危险因素。
本研究纳入了8名男性和12名女性抑郁症患者，根据DSM-IV标准进行诊断。受试者年龄在19至50岁之间，不吸烟，体重指数（BMI）、稳态模型评估估计的胰岛素抵抗（HOMA-IR）值、血压、血糖、胰岛素和血脂水平正常。开始舍曲林治疗（50毫克/天）。患有糖尿病、心脏病、妊娠的患者以及正在服用其他药物的患者被排除在研究之外。在患者服用舍曲林治疗前以及治疗后第4、8和12周测量血糖、胰岛素、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯值。此外，在治疗开始时和结束时（第12周）测量糖化血红蛋白（HbA1C）水平。
与治疗前值相比，舍曲林治疗第12周时的体格检查（血压、BMI、体重、身高、腰围）和实验室检查结果（血糖、HDL-C、LDL-C、HOMA-IR和HbA1C水平）无显著差异。然而，与治疗前值相比，第4、8和12周时的胰岛素水平显著升高。同样，与治疗前值相比，第8和12周时的甘油三酯水平显著升高。
接受舍曲林治疗的患者必须对血胰岛素和甘油三酯水平进行随访。此外，需要根据需要调整他们的治疗方案，以预防可能的代谢变化。
