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利培酮致初治儿童和青少年高催乳素血症对脂代谢的短期影响。

The short-term effects of risperidone-induced hyperprolactinemia on lipid metabolism in drug-naïve children and adolescents.

机构信息

Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.

出版信息

Psychiatry Investig. 2015 Jan;12(1):55-60. doi: 10.4306/pi.2015.12.1.55. Epub 2015 Jan 12.

Abstract

OBJECTIVE

The present cross-sectional study was designed to assess the risk of elevated prolactin levels and other hormonal or metabolic changes in children and adolescents taking risperidone.

METHODS

Twenty-five children and adolescents [aged 7-18 years, 12.1±3.3 years (mean±SD); 19 boys and 6 girls] who had been taking risperidone for at least 3 months were enrolled. The following blood parameters were measured: serum levels of prolactin, thyroid hormones, alanine transaminase (ALT), sex hormones, lipids.

RESULTS

The median risperidone dosage was 1.55 mg/day (SD 1.14 mg/day, range 0.25-4.00 mg/day). The prolactin level (33.65±16.71 ng/mL, range 5.8-68.3 ng/mL) was higher than normal, and was elevated (≥15 ng/mL in male, ≥23.3 ng/mL in female) in about 84% of the patients. The dosage of risperidone was positively correlated with serum prolactin level (r=0.767, p<0.001). The TG/HDL ratio was higher in the group with higher prolactin levels (i.e., ≥30 ng/mL), and hence might be a useful marker of insulin resistance.

CONCLUSION

In young patients taking risperidone, a high serum prolactin level may influence lipid metabolism, even when cholesterol levels are within the normal range. Further investigation is needed around this issue. Serum prolactin assessment is recommended for children and adolescents taking risperidone.

摘要

目的

本横断面研究旨在评估服用利培酮的儿童和青少年出现催乳素水平升高和其他激素或代谢变化的风险。

方法

纳入了 25 名儿童和青少年(年龄 7-18 岁,12.1±3.3 岁[均值±标准差];19 名男性和 6 名女性),他们至少服用利培酮 3 个月。测量了以下血液参数:催乳素、甲状腺激素、丙氨酸氨基转移酶(ALT)、性激素和血脂水平。

结果

中位数利培酮剂量为 1.55 毫克/天(标准差 1.14 毫克/天,范围 0.25-4.00 毫克/天)。催乳素水平(33.65±16.71ng/mL,范围 5.8-68.3ng/mL)高于正常值,约 84%的患者催乳素升高(男性≥15ng/mL,女性≥23.3ng/mL)。利培酮剂量与血清催乳素水平呈正相关(r=0.767,p<0.001)。催乳素水平较高(即≥30ng/mL)的患者中 TG/HDL 比值较高,因此可能是胰岛素抵抗的有用标志物。

结论

在服用利培酮的年轻患者中,高血清催乳素水平可能会影响脂质代谢,即使胆固醇水平在正常范围内。需要进一步研究这一问题。建议对服用利培酮的儿童和青少年进行血清催乳素评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f00e/4310921/a0e37732c231/pi-12-55-g001.jpg

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