Purohit Purvi, Nebhinani Naresh, Sharma Praveen
Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Indian J Psychol Med. 2017 May-Jun;39(3):299-305. doi: 10.4103/0253-7176.207330.
There is a paucity of data on frequency of metabolic syndrome (MS), insulin resistance (IR), and oxidative stress in Indian opiate users without comorbidities.
To determine the influence of opiate use on frequency of MS, homeostasis model assessment for IR (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), and oxidative stress in opiate-dependent male patients without comorbidities.
Participants ( = 120) were grouped as controls (Group I), pure opiate dependents (Group II), opiate + tobacco dependents (Group III), and tobacco dependents (Group IV) with a minimum of 1-year dependence participated in the study. Participants were evaluated for anthropometric parameters, blood pressure (BP), fasting blood sugar, insulin, HOMA-IR, lipid profile, hs-CRP, and total antioxidant status (TAS). Frequency of MS was determined based on modified Adult Treatment Panel-III. The data were analyzed using one-way ANOVA, multiple regression by SPSS 21.
Frequency of MS in opiate dependents was higher than control. There was a significant difference in serum insulin, HOMA-IR, and TAS levels of the study groups. Multiple regression analysis showed dependence years, body mass index, waist-hip ratio, systolic blood pressure, diastolic blood pressure (DBP), HOMA-IR, and hs-CRP to be significant independent predictors of TAS in Group II and III patients with MS after adjusting for age and education years. TAS and DBP significantly predicted hs-CRP after adjusting for age and education years in Group II and III patients with MS. No such relation was seen in Group I and IV.
Chronic opiate-dependent males without comorbidity are a unique group that shows low-grade inflammation, oxidative stress, and prevalence of MS predisposing them to future risk of cardiovascular diseases.
关于无合并症的印度阿片类药物使用者中代谢综合征（MS）、胰岛素抵抗（IR）和氧化应激频率的数据较少。
确定阿片类药物使用对无合并症的阿片类药物依赖男性患者中MS频率、IR的稳态模型评估（HOMA-IR）、高敏C反应蛋白（hs-CRP）和氧化应激的影响。
将参与者（n = 120）分为对照组（I组）、单纯阿片类药物依赖者（II组）、阿片类药物+烟草依赖者（III组）和烟草依赖者（IV组），研究纳入了至少有1年依赖史的参与者。对参与者进行人体测量参数、血压（BP）、空腹血糖、胰岛素、HOMA-IR、血脂谱、hs-CRP和总抗氧化状态（TAS）的评估。基于改良的成人治疗小组III来确定MS的频率。使用单因素方差分析进行数据分析，通过SPSS 21进行多元回归分析。
阿片类药物依赖者中MS的频率高于对照组。各研究组的血清胰岛素、HOMA-IR和TAS水平存在显著差异。多元回归分析显示，在调整年龄和受教育年限后，依赖年限、体重指数、腰臀比、收缩压、舒张压（DBP）、HOMA-IR和hs-CRP是II组和III组患有MS患者TAS的显著独立预测因素。在II组和III组患有MS的患者中，调整年龄和受教育年限后，TAS和DBP显著预测hs-CRP。I组和IV组未观察到这种关系。
无合并症的慢性阿片类药物依赖男性是一个独特的群体，表现出低度炎症、氧化应激和MS患病率，使他们易患未来心血管疾病风险。
