精神科住院患者中无症状脑梗死增加，伴有糖尿病和血脂异常的高患病率：一项横断面研究。
Increased Silent Brain Infarction Accompanied With High Prevalence of Diabetes and Dyslipidemia in Psychiatric Inpatients: A Cross-Sectional Study.
作者信息
Kanzaki Tetsuto, Uju Yoriyasu, Sekine Keisuke, Ishii Yukihiro, Yoshimi Taro, Yasui Reiko, Yasukawa Asuka, Sato Mamoru, Okamoto Seiko, Hisaoka Tetsuya, Miura Masafumi, Kusanishi Shun, Murakami Kanako, Nakano Chieko, Mizuta Yasuhiko, Mimori Seisuke, Mishima Shunichi, Igarashi Kazuei, Takizawa Tsuyoshi, Hayakawa Tatsuro, Tsukada Kazumi
机构信息
Department of Clinical Medicine (Drs Kanzaki and Mimori) and Department of Biostatistics (Dr Takizawa), Faculty of Pharmacy, Chiba Institute of Science, Choshi City; Department of Psychiatry (Drs Uju, Sekine, Ishii, Yoshimi, Yasui, Yasukawa, Sato, Okamoto, Hisaoka, Miura, Kusanishi, Murakami, Nakano, Mizuta, Hayakawa, and Tsukada) and Department of Internal Medicine (Dr Mishima), Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa City; and Amine Pharma Research Institute, Innovation Plaza at Chiba University, Chiba City (Dr Igarashi), Japan.
出版信息
Prim Care Companion CNS Disord. 2015 Mar 26;17(2). doi: 10.4088/PCC.14m01713. eCollection 2015.
OBJECTIVE
Patients with schizophrenia have increased risk of atherosclerotic diseases. It is already known that lifestyle-related disorders and the use of antipsychotics are closely related with the progression of atherosclerosis in psychiatric patients. Stroke as well as coronary heart disease play an important role in the cause of death in Asia and Japan. Thus, we studied the prevalence of cerebrovascular disease in psychiatric inpatients in Japan using brain magnetic resonance imaging (MRI).
METHOD
This cross-sectional study was performed from January 2012 to December 2013. Study participants were 152 hospitalized patients (61 men and 91 women) in the Department of Psychiatry at Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa City, Japan. Mean ages were 50.0 and 57.1 years old for men and women, respectively. The diagnoses (DSM-IV-TR criteria) of participants were schizophrenia (69.1%), mood disorder (18.4%), and other mental disorders (12.5%). We checked physical status, metabolic status of glucose and lipid levels, and brain MRI within 1 week of admission.
RESULTS
The study group showed a significantly high prevalence of diabetes and low high-density lipoprotein (HDL) cholesterolemia in both sexes (n = 61 in men, n = 91 in women, P < .05). In the study group, serum fasting plasma glucose and hemoglobin A1c levels were significantly high (n = 152, P < .05), but serum HDL cholesterol and total cholesterol were significantly low in both sexes (n = 61 in men, n = 90 in women, P < .05), and triglycerides were low in men (n = 61, P < .05). Silent brain infarction was recognized at a higher rate (n = 98, P < .05) compared with healthy controls.
CONCLUSIONS
Participants in this study had an increased ratio of silent brain infarction compared with Japanese healthy controls, accompanied with higher ratios of diabetes and low HDL cholesterol.
目的
精神分裂症患者患动脉粥样硬化疾病的风险增加。已知与生活方式相关的疾病以及抗精神病药物的使用与精神科患者动脉粥样硬化的进展密切相关。中风和冠心病在亚洲和日本的死因中起着重要作用。因此，我们使用脑磁共振成像（MRI）研究了日本精神科住院患者中脑血管疾病的患病率。
方法
这项横断面研究于2012年1月至2013年12月进行。研究参与者为日本市川市国立全球健康与医学中心小田医院精神科的152名住院患者（61名男性和91名女性）。男性和女性的平均年龄分别为50.0岁和57.1岁。参与者的诊断（DSM-IV-TR标准）为精神分裂症（69.1%）、情绪障碍（18.4%）和其他精神障碍（12.5%）。我们在入院后1周内检查了身体状况、血糖和血脂水平的代谢状况以及脑部MRI。
结果
研究组中，男女糖尿病患病率均显著较高，高密度脂蛋白（HDL）胆固醇血症较低（男性61例，女性91例，P < 0.05）。在研究组中，空腹血糖和糖化血红蛋白A1c水平显著较高（n = 152，P < 0.05），但男女血清HDL胆固醇和总胆固醇均显著较低（男性61例，女性90例，P < 0.05），男性甘油三酯水平较低（n = 61，P < 0.05）。与健康对照组相比，无症状脑梗死的发生率更高（n = 98，P < 0.05）。
结论
与日本健康对照组相比，本研究中的参与者无症状脑梗死的比例增加，同时糖尿病和低HDL胆固醇的比例更高。
Zotero 插件