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双相障碍患者的 2 型糖尿病和糖尿病前期异常。

Type 2 diabetes and pre-diabetic abnormalities in patients with bipolar disorders.

机构信息

Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Germany.

Department of Psychiatry and Psychotherapy, University Hospital Würzburg, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt/Main, Germany.

出版信息

J Affect Disord. 2016 Jan 1;189:240-5. doi: 10.1016/j.jad.2015.09.041. Epub 2015 Sep 28.

Abstract

BACKGROUND

Abnormalities in the glucose metabolism cause nervous and organic damage and are a cardiovascular risk factor. They could be a main cause for the increased morbidity and mortality rates found in patients with bipolar disorders. The exact prevalence of diabetes and pre-diabetic abnormalities, however, is not clear.

METHODS

85 euthymic outpatients with bipolar disorders from two university hospitals in Germany underwent an oral glucose tolerance test, laboratory screening and clinical measurements. Socio-demographic data, medication, severity of illness, global functioning and life quality were assessed.

RESULTS

Diabetes mellitus was found in 7% of the patients, pre-diabetic abnormalities in 27%. The group of patients with abnormalities in the glucose metabolism had significantly lower quality of life and global functioning. Higher BMI, leptin, triglycerides and CRP levels significantly increased the likelihood for pre-diabetes/diabetes.

LIMITATIONS

The low sample size did only allow limited assessment of impact of medication on the results. No healthy controls were assessed.

CONCLUSIONS

One-third of the patients with bipolar disorders showed abnormalities in the glucose metabolism and this was associated with impaired global functioning and lower quality of life. Early detection and intervention strategies fitting the needs of patient with bipolar disorder are needed to improve both physical and mental health.

摘要

背景

葡萄糖代谢异常会导致神经和器官损伤,是心血管疾病的一个风险因素。这种异常可能是导致双相情感障碍患者发病率和死亡率升高的一个主要原因。然而,确切的糖尿病和糖尿病前期异常的患病率尚不清楚。

方法

德国两所大学附属医院的 85 名病情稳定的双相情感障碍门诊患者接受了口服葡萄糖耐量试验、实验室筛查和临床测量。评估了社会人口统计学数据、药物治疗、疾病严重程度、整体功能和生活质量。

结果

7%的患者被诊断为糖尿病,27%的患者存在糖尿病前期异常。葡萄糖代谢异常组患者的生活质量和整体功能明显下降。更高的 BMI、瘦素、甘油三酯和 CRP 水平显著增加了患糖尿病前期/糖尿病的可能性。

局限性

样本量低仅允许对药物治疗对结果的影响进行有限的评估。未评估健康对照组。

结论

三分之一的双相情感障碍患者存在葡萄糖代谢异常,这与整体功能下降和生活质量降低有关。需要针对双相情感障碍患者的需求制定早期检测和干预策略,以改善身心健康。

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