Institute of Mental Health, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
Psychopharmacology (Berl). 2013 Sep;229(1):1-7. doi: 10.1007/s00213-013-3193-7. Epub 2013 Jul 6.
The development of atypical antipsychotic (AAP) drugs has brought about dramatic improvement in the function of many patients with schizophrenia and related mental disorders. However, prescription of AAPs is frequently associated with the emergence of weight gain, hypertriglyceridemia, and other metabolic disturbances. Although the mechanisms involved in AAP-induced hypertriglyceridemia remain to be fully elucidated, several studies have proposed that this side effect may be associated with weight gain and obesity. Recently, special emphasis has been placed on the evidence indicating a direct effect of AAPs on triglyceride metabolism.
In this review, we highlight recent findings discussing the potential mechanisms by which AAPs may contribute to hypertriglyceridemia. In addition, we summarize the adjunctive pharmacologic treatments for AAP-associated dyslipidemia.
There is evidence that AAPs may cause hypertriglyceridemia through several possible mechanisms: (1) a direct effect on triglyceride metabolism either by stimulation of hepatic triglyceride production and secretion or by inhibition of lipoprotein lipase-mediated triglyceride hydrolysis and (2) an indirect mechanism associated with obesity and insulin resistance. The practical applications of this manuscript provide new insights for the future investigation of AAPs.
非典型抗精神病药物（AAP）的发展显著改善了许多精神分裂症和相关精神障碍患者的功能。然而，AAP 的处方常常与体重增加、高三酰甘油血症和其他代谢紊乱有关。尽管 AAP 引起的高三酰甘油血症的机制仍未完全阐明，但有几项研究提出，这种副作用可能与体重增加和肥胖有关。最近，人们特别强调了 AAP 对甘油三酯代谢有直接影响的证据。
在这篇综述中，我们强调了最近的研究结果，讨论了 AAP 可能导致高三酰甘油血症的潜在机制。此外，我们总结了 AAP 相关血脂异常的辅助药物治疗。
有证据表明，AAP 可能通过几种可能的机制导致高三酰甘油血症：（1）通过刺激肝甘油三酯的产生和分泌，或通过抑制脂蛋白脂肪酶介导的甘油三酯水解，对甘油三酯代谢产生直接影响；（2）与肥胖和胰岛素抵抗相关的间接机制。本文的实际应用为 AAP 的未来研究提供了新的见解。
