Enez Darcin Aslı, Yalcin Cavus Sercin, Dilbaz Nesrin, Kaya Hasan, Dogan Eylem
Kanuni SS Training and Research Hospital, Turkey.
Madalyon Psychiatry Center, Turkey.
Schizophr Res. 2015 Aug;166(1-3):201-6. doi: 10.1016/j.schres.2015.05.004. Epub 2015 May 21.
We tested the hypothesis that metabolic disturbances in people with schizophrenia exist as a part of the schizophrenic syndrome, even when the antipsychotic drug effect is eliminated. We aimed to determine the prevalence of metabolic syndrome among patients with schizophrenia who were antipsychotic drug-naive or drug-free and their siblings for comparison with healthy controls.
One-hundred-two patients with schizophrenia (drug-naïve or drug-free), 64 siblings and 70 age-matched healthy subjects were recruited for this case-control study. Metabolic syndrome was assessed based on Adult Treatment Panel (ATP) III, adapted ATP III and International Diabetes Federation criteria. Student's t-tests, chi-squared tests, Kruskal-Wallis tests and Bonferroni corrections were used as appropriate.
The diagnoses of metabolic syndrome and metabolic disturbances as a subsyndromal state were found to be significantly more frequent in patients and their siblings than in the controls. Low levels of high-density lipoprotein cholesterol and disturbances in blood pressure put the patient group at risk for metabolic syndrome even before they were exposed to antipsychotic drugs.
Although antipsychotic drugs have consistently been related to disturbances of glucose and lipid metabolism in patients with schizophrenia, this study showed that patients with schizophrenia and their siblings are already at a high risk for metabolic syndrome independent of any antipsychotic effects. These individuals should be monitored regularly following a diagnosis of schizophrenia.
我们检验了这样一种假设，即精神分裂症患者的代谢紊乱是精神分裂症综合征的一部分，即使消除抗精神病药物的作用也是如此。我们旨在确定未使用过抗精神病药物或已停药的精神分裂症患者及其兄弟姐妹中代谢综合征的患病率，并与健康对照进行比较。
本病例对照研究招募了102例未使用过抗精神病药物或已停药的精神分裂症患者、64名兄弟姐妹和70名年龄匹配的健康受试者。根据成人治疗小组（ATP）III、修订版ATP III和国际糖尿病联盟标准评估代谢综合征。酌情使用学生t检验、卡方检验、Kruskal-Wallis检验和Bonferroni校正。
发现患者及其兄弟姐妹中代谢综合征和作为亚综合征状态的代谢紊乱的诊断显著多于对照组。即使在未接触抗精神病药物之前，患者组的高密度脂蛋白胆固醇水平低和血压紊乱就使其有患代谢综合征的风险。
尽管抗精神病药物一直与精神分裂症患者的糖脂代谢紊乱有关，但本研究表明，精神分裂症患者及其兄弟姐妹独立于任何抗精神病作用，已经处于患代谢综合征的高风险中。这些个体在被诊断为精神分裂症后应定期接受监测。
