Olguner Eker Özlem, Özsoy Saliha, Eker Baki, Doğan Hatice
Department of Psychiatry, Kayseri Training and Research Hospital, Kayseri, Turkey.
Department of Psychiatry, Erciyes University School of Medicine, Kayseri, Turkey.
Noro Psikiyatr Ars. 2017 Mar;54(1):49-56. doi: 10.5152/npa.2016.12373. Epub 2017 Mar 1.
This study aimed to investigate body measurements, glucose-insulin metabolism, and lipid profile in patients with anxiety and depressive symptoms and also the effects of antidepressant drugs on these metabolic parameters.
The study included 40 outpatients and 32 healthy controls. The patients received antidepressant treatment (sertraline, escitalopram, fluoxetine, and venlafaxine) for 8 weeks. Body measurements were performed, and lipid, fasting blood glucose, and insulin levels were measured before and after treatment in patients and once in healthy controls. Insulin resistance was evaluated using the homeostasis model assessment (HOMA) index.
Body mass index was higher in patients than in healthy controls, and there was no change in patients after treatment. In patients, high-density lipoprotein (HDL) cholesterol levels increased owing to the antidepressant treatment. Insulin level and HOMA index had a tendency to decrease with the treatment in patients and were similar to those of healthy controls before the treatment; however, they became lower than those of healthy controls after the treatment. There was an increase in waist circumference and total and HDL cholesterol levels, whereas there was a decrease in fasting blood glucose levels with treatment in patients using escitalopram. There was no change in body measurements and biochemical and hormone values in patients using fluoxetine, sertraline, and venlafaxine. There was an increase in weight, body mass index, and waist circumference after treatment in patients with depression; however, there was no change in patients with anxiety.
In patients with psychiatric disorders having anxiety and depressive symptoms, metabolic changes independent of drugs and the metabolic effects of drugs are present.
本研究旨在调查伴有焦虑和抑郁症状的患者的身体测量指标、葡萄糖-胰岛素代谢及血脂情况，以及抗抑郁药物对这些代谢参数的影响。
该研究纳入了40名门诊患者和32名健康对照者。患者接受抗抑郁治疗（舍曲林、艾司西酞普兰、氟西汀和文拉法辛）8周。对患者进行身体测量，并在治疗前后测量其血脂、空腹血糖和胰岛素水平，对健康对照者仅测量一次。使用稳态模型评估（HOMA）指数评估胰岛素抵抗。
患者的体重指数高于健康对照者，且治疗后患者的体重指数无变化。在患者中，抗抑郁治疗使高密度脂蛋白（HDL）胆固醇水平升高。患者的胰岛素水平和HOMA指数在治疗后有下降趋势，且治疗前与健康对照者相似；然而，治疗后低于健康对照者。使用艾司西酞普兰治疗的患者，腰围、总胆固醇和HDL胆固醇水平升高，而空腹血糖水平下降。使用氟西汀、舍曲林和文拉法辛治疗的患者，身体测量指标、生化和激素值无变化。抑郁症患者治疗后体重、体重指数和腰围增加；然而，焦虑症患者无变化。
在伴有焦虑和抑郁症状的精神疾病患者中，存在与药物无关的代谢变化以及药物的代谢作用。
