McAvoy Sarah, Cordiner Matthew, Kelly Jackie, Chiwanda Laura, Jefferies Christine, Miller Kirsteen, Shajahan Polash
NHS Lanarkshire, Scotland, UK.
NHS Lanarkshire, Scotland, UK; University of Glasgow, Scotland, UK.
BJPsych Bull. 2016 Jun;40(3):127-31. doi: 10.1192/pb.bp.115.051219.
Aims and method Using a retrospective observational approach, we aimed to discern whether there was a difference in metabolic parameters between psychiatric and general practice populations in the same locality. Second, we aimed to establish differences in metabolic parameters of patients taking olanzapine, clozapine or aripiprazole. Results Patients with psychiatric illness had a body mass index (BMI) comparable to that of the general practice population (28.7 v. 29.7 kg/m(2)), but blood glucose was significantly lower in the general practice population (4.8 v. 6.1 mmol/L). Olanzapine was associated with the lowest BMI (26.1 kg/m(2)) and aripiprazole the highest (32.2 kg/m(2)), with no difference in blood glucose between antipsychotics. Clinical implications Awareness of environmental factors and how they affect individuals is important and medications are not the only cause of metabolic effects. There may be a channelling bias present, meaning practitioners are cognisant of potential metabolic effects prior to prescribing. Overall monitoring of physical health is important regardless of potential cause.
目的与方法 采用回顾性观察方法,我们旨在辨别同一地区精神科人群与全科医疗人群在代谢参数上是否存在差异。其次,我们旨在确定服用奥氮平、氯氮平或阿立哌唑的患者在代谢参数上的差异。结果 患有精神疾病的患者的体重指数(BMI)与全科医疗人群相当(28.7对29.7kg/m²),但全科医疗人群的血糖显著更低(4.8对6.1mmol/L)。奥氮平与最低的BMI(26.1kg/m²)相关,阿立哌唑与最高的BMI(32.2kg/m²)相关,抗精神病药物之间的血糖无差异。临床意义 了解环境因素及其如何影响个体很重要,药物并非代谢效应的唯一原因。可能存在转诊偏倚,这意味着从业者在开处方前就已认识到潜在的代谢效应。无论潜在原因如何,对身体健康进行全面监测都很重要。