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接受氯氮平单一疗法的精神分裂症患者的尿酸水平

Uric acid levels in patients with schizophrenia on clozapine monotherapy.

作者信息

Wysokiński Adam, Kłoszewska Iwona

机构信息

Adam Wysokiński, M.D., Ph.D., Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz , Czechosłowacka 8/10, 92-216 Łód , Poland.

出版信息

Nord J Psychiatry. 2015 Aug;69(6):453-8. doi: 10.3109/08039488.2014.1002420. Epub 2015 Mar 24.

Abstract

BACKGROUND

We tested the hypothesis that uric acid levels are higher in subjects with schizophrenia treated with clozapine than in healthy control and they correlate with anthropometric measurements, laboratory tests and results of bioimpedance analysis of body composition.

METHODS

Data for 24 subjects with schizophrenia treated with clozapine and 24 age- and sex-matched healthy volunteers was analyzed.

RESULTS

There was no difference of fasting uric acid concentrations between clozapine and control groups (4.5 ± 1.4 vs. 4.3 ± 1.3 mg/dl, P = 0.87). Regarding the whole group, uric acid levels were significantly higher in men (5.2 ± 1.2 vs. 3.6 ± 0.9, P < 0.001). Uric acid levels correlated with weight (R = 0.58, P = 0.003), body mass index (BMI; R = 0.49, P = 0.01), abdominal circumference (R = 0.45, P = 0.03), waist circumference (R = 0.47, P = 0.02), waist-to-hip ratio (R = 0.42, P = 0.04), insulin (R = 0.50, P = 0.01), homoeostasis model assessment of insulin resistance 2 (HOMA2-IR; R = 0.49, P = 0.01), basal metabolic rate (R = 0.56, P = 0.004), lean body mass (R = 0.55, P = 0.005) and body water (R = 0.55, P = 0.005). There were no significant differences of uric acid levels for smoking status, impaired fasting glucose, abdominal obesity, obesity/overweight and dyslipidemia. Uric acid levels did not correlate with age, duration of clozapine treatment, clozapine dose, leg circumference, systolic blood pressure, diastolic blood pressure, total body fat, triglycerides, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), homocysteine, corrected calcium, glucose and homoeostasis model assessment of insulin resistance 1 (HOMA1-IR).

CONCLUSIONS

We did not find significant differences in blood uric acid levels between subjects with schizophrenia and controls. Association with weight, BMI, abdominal and waist circumferences, insulin levels and insulin resistance may support uric acid role as an important cardiovascular risk factor. Association with lean weight may explain why men have higher levels of uric acid than women.

摘要

背景

我们检验了以下假设:接受氯氮平治疗的精神分裂症患者的尿酸水平高于健康对照者,且尿酸水平与人体测量指标、实验室检查以及身体成分生物电阻抗分析结果相关。

方法

分析了24例接受氯氮平治疗的精神分裂症患者以及24例年龄和性别匹配的健康志愿者的数据。

结果

氯氮平组与对照组的空腹尿酸浓度无差异(4.5±1.4 vs. 4.3±1.3mg/dl,P = 0.87)。在整个研究组中,男性的尿酸水平显著更高(5.2±1.2 vs. 3.6±0.9,P < 0.001)。尿酸水平与体重(R = 0.58,P = 0.003)、体重指数(BMI;R = 0.49,P = 0.01)、腹围(R = 0.45,P = 0.03)、腰围(R = 0.47,P = 0.02)、腰臀比(R = 0.42,P = 0.04)、胰岛素(R = 0.50,P = 0.01)、胰岛素抵抗稳态模型评估2(HOMA2-IR;R = 0.49,P = 0.01)、基础代谢率(R = 0.56,P = 0.004)、去脂体重(R = 0.55,P = 0.005)和身体水分(R = 0.55,P = 0.005)相关。尿酸水平在吸烟状况、空腹血糖受损、腹型肥胖、肥胖/超重和血脂异常方面无显著差异。尿酸水平与年龄、氯氮平治疗时间、氯氮平剂量、腿围、收缩压、舒张压、体脂总量、甘油三酯、总胆固醇、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、同型半胱氨酸、校正钙、血糖和胰岛素抵抗稳态模型评估1(HOMA1-IR)无关。

结论

我们未发现精神分裂症患者与对照组之间血尿酸水平存在显著差异。尿酸与体重、BMI、腹围和腰围、胰岛素水平及胰岛素抵抗的相关性可能支持尿酸作为重要心血管危险因素的作用。尿酸与去脂体重的相关性可能解释了为何男性尿酸水平高于女性。

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