Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Acta Psychiatr Scand. 2015 Aug;132(2):86-96. doi: 10.1111/acps.12443. Epub 2015 May 15.
Primary prevention of diabetes and cardiovascular disease is an important priority for people with schizophrenia. This review aims to identify lifestyle and pharmacological interventions that reduce diabetes and cardiovascular disease in people with schizophrenia.
PubMed and other electronic databases were searched to identify relevant articles.
Lifestyle interventions that focus on diet and physical activity reduce the incidence of diabetes. Similar programmes in people with schizophrenia have led to significant weight loss and may reasonably be expected to reduce diabetes in the long-term. Metformin may be considered when lifestyle change is not feasible or effective. Lifestyle interventions, particularly smoking cessation, are likely to be effective in reducing cardiovascular disease in people with schizophrenia. Although cardiovascular prevention trials with statins have not been performed in people with schizophrenia, similar reductions in cholesterol has been seen as in the general population and statins should be considered for those at high risk. Traditional cardiovascular risk prediction models perform well in identifying those at high cardiovascular risk, but bespoke prediction models using data from people with schizophrenia perform better.
Reducing diabetes and cardiovascular disease requires a coordinated and concerted effort from mental and physical health teams working across primary and secondary care.
预防糖尿病和心血管疾病是精神分裂症患者的重要优先事项。本综述旨在确定可降低精神分裂症患者糖尿病和心血管疾病风险的生活方式和药物干预措施。
检索 PubMed 和其他电子数据库，以确定相关文章。
专注于饮食和体育锻炼的生活方式干预措施可降低糖尿病的发病率。在精神分裂症患者中实施类似的方案已导致显著的体重减轻，并且从长期来看可能合理地降低糖尿病的风险。如果生活方式改变不可行或无效，则可以考虑使用二甲双胍。生活方式干预措施，特别是戒烟，可能会有效降低精神分裂症患者的心血管疾病风险。尽管尚未在精神分裂症患者中进行他汀类药物心血管预防试验，但在一般人群中已观察到类似的胆固醇降低，因此应考虑对高风险人群使用他汀类药物。传统的心血管风险预测模型在识别高心血管风险方面表现良好，但使用来自精神分裂症患者的数据的定制预测模型表现更好。
要降低糖尿病和心血管疾病的风险，需要精神和身体健康团队在初级和二级保健中进行协调一致的努力。
