Garcia-Rizo C, Fernandez-Egea E, Oliveira C, Meseguer A, Cabrera B, Mezquida G, Bioque M, Penades R, Parellada E, Bernardo M, Kirkpatrick B
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, CB2 0QQ Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Huntingdon PE29 3RJ, UK.
Eur Psychiatry. 2017 Mar;41:42-46. doi: 10.1016/j.eurpsy.2016.10.001. Epub 2017 Feb 3.
Patients with schizophrenia exhibit a reduced life expectancy. Although unhealthy lifestyle or suicide risk plays a role, the main causes are diverse medical conditions such as cardiovascular diseases, type 2 diabetes mellitus and metabolic syndrome. Albeit pharmacological secondary side effects might also trigger previous conditions, studies in naïve patients reflect diverse anomalies at the onset. Patients with a first episode of psychosis, display a wide scope of metabolic abnormalities, ranging from normality till pathological values depending on the parameters studied. We attempted to evaluate the metabolic syndrome and glycemic homeostasis in a subset of antipsychotic-naïve patients with a first episode of non-affective psychosis. Patients (n=84) showed a similar prevalence of metabolic syndrome compared with a matched control sample (n=98) (6% vs 4%, P=0.562), while glucose homeostasis values differed significantly (14% vs. 5%, P=0.034). Our results suggest that metabolic syndrome is not a useful clinical condition to be evaluated in patients before pharmacological treatment. Abnormal glycemic homeostasis at the onset of the disease requires specific diagnostic tools and preventive measures in order to avoid future cardiovascular events. New strategies must be implemented in order to evaluate the cardiovascular risk and subsequent morbidity in patients at the onset of the disease.
精神分裂症患者的预期寿命缩短。尽管不健康的生活方式或自杀风险起了一定作用，但主要原因是多种医学状况，如心血管疾病、2型糖尿病和代谢综合征。虽然药物的继发副作用也可能引发先前存在的状况，但对初治患者的研究反映出在疾病发作时存在多种异常。首次发作精神病的患者，根据所研究的参数，表现出广泛的代谢异常，从正常到病理值不等。我们试图评估一组初治的首次发作非情感性精神病患者的代谢综合征和血糖稳态。与匹配的对照样本（n = 98）相比，患者（n = 84）的代谢综合征患病率相似（6% 对 4%，P = 0.562），而血糖稳态值有显著差异（14% 对 5%，P = 0.034）。我们的结果表明，代谢综合征并非药物治疗前患者需要评估的有用临床指标。疾病发作时血糖稳态异常需要特定的诊断工具和预防措施，以避免未来发生心血管事件。必须实施新的策略来评估疾病发作时患者的心血管风险及随后的发病率。
