Rout Jayanta Kumar, Dasgupta Anindya, Singh Om Prakash, Banerjee Ushasi, Das Brahmarshi
Department of Biochemistry, Burdwan Medical College, Burdwan, W.B, India.
J Neurosci Rural Pract. 2012 Sep;3(3):277-82. doi: 10.4103/0976-3147.102605.
For any given body mass, Asian Indians have higher central obesity than Europeans. A periodic measurement of body mass index (BMI) and waist hip ratio (WHR) is practically more feasible than other parameters of metabolic syndrome by repeated blood collection. However, few studies are available on the relative importance of BMI and WHR as markers of dyslipidemia and insulin resistance in schizophrenia patients stabilized on second generation antipsychotics in Indian population.
We conducted the present study on such patients to examine whether BMI or WHR can better predict dyslipidemia and insulin resistance in these patients in a rural area.
The study was a hospital based case control study under rural settings on 38 schizophrenia patients stabilized on olanzapine and 30 matched controls.
Fasting concentrations of blood glucose, lipid parameters and serum insulin were assessed. Data for Homeostatic model for assessment of insulin resistance (HOMA-IR), BMI, and WHR were obtained to assess the insulin resistance, overall body fat distribution and abdominal fat dispensation respectively.
't' test was performed to assay any difference in corresponding mean values between cases and controls. Dependence of HOMA-IR on key parameters was assessed by analysis of co-variance (ANCOVA) study.
Cases exhibited significantly higher values for HOMA-IR, serum triglyceride and low density lipoprotein cholesterol (LDLc) with a significantly lower high density lipoprotein cholesterol (HDLc) level. ANCOVA study reflected that irrespective of age and sex, HOMA-IR was dependent on serum triglyceride level and WHR (F=8.3 and 5.7 respectively, P<0.05), but not on BMI (F<0.001, P=0.997).
Central obesity could be more closely associated with the pathogenesis of prediabetic state in our case group. So, WHR is a better anthropometric parameter than BMI for an early assessment of insulin resistance and dyslipidemia in schizophrenia patients stabilized on olanzapine in our region.
对于任何给定的体重，亚洲印度人比欧洲人有更高的中心性肥胖。通过重复采血来定期测量体重指数（BMI）和腰臀比（WHR）实际上比代谢综合征的其他参数更可行。然而，关于在印度人群中使用第二代抗精神病药物稳定治疗的精神分裂症患者中，BMI和WHR作为血脂异常和胰岛素抵抗标志物的相对重要性的研究很少。
我们对这类患者进行了本研究，以检查BMI或WHR是否能更好地预测农村地区这些患者的血脂异常和胰岛素抵抗。
该研究是一项基于医院的病例对照研究，在农村环境中对38名使用奥氮平稳定治疗的精神分裂症患者和30名匹配对照进行研究。
评估空腹血糖、血脂参数和血清胰岛素浓度。获取稳态模型评估胰岛素抵抗（HOMA-IR）、BMI和WHR的数据，分别用于评估胰岛素抵抗、总体脂肪分布和腹部脂肪分布。
采用“t”检验分析病例组和对照组相应平均值之间的差异。通过协方差分析（ANCOVA）研究评估HOMA-IR对关键参数的依赖性。
病例组的HOMA-IR、血清甘油三酯和低密度脂蛋白胆固醇（LDLc）值显著更高，高密度脂蛋白胆固醇（HDLc）水平显著更低。ANCOVA研究表明，无论年龄和性别如何，HOMA-IR均依赖于血清甘油三酯水平和WHR（F分别为8.3和5.7，P<0.05），但不依赖于BMI（F<0.001，P = 0.997）。
在我们的病例组中，中心性肥胖可能与糖尿病前期状态的发病机制更密切相关。因此，对于我们地区使用奥氮平稳定治疗的精神分裂症患者，WHR是比BMI更好的人体测量参数，可用于早期评估胰岛素抵抗和血脂异常。
