Miller Brian J, Goldsmith David R, Paletta Nina, Wong Joyce, Kandhal Prianka, Black Carmen, Rapaport Mark Hyman, Buckley Peter F
Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, USA.
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
Schizophr Res. 2016 Aug;175(1-3):223-225. doi: 10.1016/j.schres.2016.04.035. Epub 2016 May 4.
People with schizophrenia have an increased risk of diabetes that may be independent of antipsychotics. Previous studies have explored the prevalence of a family history of type 2 diabetes (DM2) in schizophrenia. We hypothesized that parental DM2 is increased in probands with non-affective psychosis (NAP) compared to controls, and parental DM2 predicts comorbid diabetes in NAP, after controlling for potential confounders.
N=217 patients with NAP and N=67 controls were interviewed for a history of parental DM2. NAP was investigated as a predictor of parental DM2 in binary logistic regression models, controlling for age, sex, race, smoking, body mass index, socioeconomic status, and parental psychiatric history.
There was an increased prevalence of DM2 in the mother (30.0% vs 13.8%, p=0.013) and in either the mother or father (44.5% vs 24.6%, p=0.006) in patients with NAP versus controls. After accounting for potential confounders, NAP was associated with significant increased odds of parental DM2 (OR=2.80, 95% CI 1.08-7.23, p=0.034). Parental DM2 was also associated with increased odds of comorbid DM2 in NAP (OR=3.67, 95% CI 1.58-8.56, p=0.003).
We replicated an association of an increased prevalence of parental DM2 in patients with NAP. Parental DM2 was also an independent predictor of comorbid DM2 in these patients. These associations may be due to shared environmental or genetic risk factors, or gene by environment interactions. Given risks of incident diabetes with antipsychotic treatment, screening for parental DM2 status is germane to the clinical care of patients with NAP.
精神分裂症患者患糖尿病的风险增加，这可能与抗精神病药物无关。以往的研究探讨了精神分裂症患者2型糖尿病（DM2）家族史的患病率。我们假设，与对照组相比，非情感性精神病（NAP）先证者的父母患DM2的比例更高，并且在控制潜在混杂因素后，父母患DM2可预测NAP患者的共病糖尿病。
对217例NAP患者和67例对照者进行访谈，了解其父母患DM2的病史。在二元逻辑回归模型中，将NAP作为父母患DM2的预测因素进行研究，同时控制年龄、性别、种族、吸烟、体重指数、社会经济地位和父母精神病史。
与对照组相比，NAP患者母亲患DM2的患病率更高（30.0%对13.8%，p=0.013），母亲或父亲患DM2的患病率更高（44.5%对24.6%，p=0.006）。在考虑潜在混杂因素后，NAP与父母患DM2的显著较高几率相关（比值比[OR]=2.80，95%置信区间[CI] 1.08 - 7.23，p=0.034）。父母患DM2也与NAP患者共病DM2的较高几率相关（OR=3.67，95% CI 1.58 - 8.56，p=0.003）。
我们重复验证了NAP患者父母患DM2患病率增加的关联。父母患DM2也是这些患者共病DM2的独立预测因素。这些关联可能是由于共同的环境或遗传风险因素，或基因与环境的相互作用。鉴于抗精神病药物治疗有引发糖尿病的风险，筛查父母的DM2状态与NAP患者的临床护理密切相关。
