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抗精神病药物治疗与首发精神病患者的炎症和代谢生物标志物改变相关:一项7个月的随访研究。

Antipsychotic treatment is associated with inflammatory and metabolic biomarkers alterations among first-episode psychosis patients: A 7-month follow-up study.

作者信息

Balõtšev Roman, Haring Liina, Koido Kati, Leping Vambola, Kriisa Kärt, Zilmer Mihkel, Vasar Veiko, Piir Anneli, Lang Aavo, Vasar Eero

机构信息

Psychiatry Clinic, Tartu University Hospital, Tartu, Estonia.

Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia.

出版信息

Early Interv Psychiatry. 2019 Feb;13(1):101-109. doi: 10.1111/eip.12457. Epub 2017 Jul 18.

Abstract

AIM

Second-generation antipsychotics are commonly used to treat schizophrenia, but may cause metabolic syndrome (MetS) in a subset of patients. The mechanisms of antipsychotic-related metabolic changes remain to be established, especially in first-episode psychosis (FEP) patients.

METHODS

In the present study, we used a chip technology to measure metabolic (C-peptide, insulin, leptin, adiponectin and resistin) and inflammatory biomarkers (ferritin, interleukin-6, interleukin-1α, tumour necrosis factor-α and plasminogen activator inhibitor-1) in the serum samples of a population of FEP patients before and after 7 months of antipsychotic drug treatment, compared to control subjects (CS).

RESULTS

The comparison of these markers in antipsychotic-naïve FEP patients (N = 38) and CS (N = 37) revealed significantly higher levels of ferritin (P = .004), and resistin (P = .03) and lower level of leptin (P = .03) among FEP patients group. Seven months of antipsychotic drug treatment in patients (N = 36) ameliorated clinical symptoms, but increased significantly body mass index (BMI; P = .002) and these changes were accompanied by increased levels of C-peptide (P = .03) and leptin (P = .02), as well as decreased level of adiponectin (P = .01).

CONCLUSIONS

Seven months of antipsychotic drug treatment suppressed the clinical symptoms of psychosis whereas caused imbalance in metabolic biomarkers and increased BMI. These findings provide insight into antipsychotic-induced MetS and refer to problems in insulin processing already present in the early stage of the chronic psychotic disorder.

摘要

目的

第二代抗精神病药物常用于治疗精神分裂症,但可能会使一部分患者出现代谢综合征(MetS)。抗精神病药物相关代谢变化的机制仍有待确定,尤其是在首发精神病(FEP)患者中。

方法

在本研究中,我们使用芯片技术测量了一组FEP患者在接受抗精神病药物治疗7个月前后血清样本中的代谢生物标志物(C肽、胰岛素、瘦素、脂联素和抵抗素)和炎症生物标志物(铁蛋白、白细胞介素-6、白细胞介素-1α、肿瘤坏死因子-α和纤溶酶原激活物抑制剂-1),并与对照组(CS)进行比较。

结果

未使用过抗精神病药物的FEP患者(N = 38)与CS组(N = 37)的这些标志物比较显示,FEP患者组中铁蛋白(P = .004)和抵抗素(P = .03)水平显著更高,而瘦素水平(P = .03)更低。患者(N = 36)接受7个月抗精神病药物治疗后临床症状有所改善,但体重指数(BMI)显著增加(P = .002),这些变化伴随着C肽水平(P = .03)和瘦素水平(P = .02)升高,以及脂联素水平降低(P = .01)。

结论

7个月的抗精神病药物治疗抑制了精神病的临床症状,但导致了代谢生物标志物失衡并增加了BMI。这些发现为抗精神病药物诱发的MetS提供了见解,并指出了慢性精神疾病早期就已存在的胰岛素处理问题。

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