Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN USA.
Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
J Affect Disord. 2020 Apr 1;266:772-781. doi: 10.1016/j.jad.2018.09.025. Epub 2018 Sep 12.
Lithium and quetiapine can cause weight gain, but their comparative longer term anthropometric effects are unknown, as are the potential moderating effects of baseline binge-eating (BE) behavior.
We assessed 6 month changes in body weight, body mass index (BMI) and waist circumference in 482 adults with DSM-IV bipolar disorders who participated in a comparative effectiveness study of lithium and quetiapine with evidence-based adjunctive treatment (Bipolar CHOICE). Anthropometric measurements were obtained at baseline, and at 2, 4, 6, 8, 12, 16, 20, and 24 weeks. BE behavior was defined as affirmative responses to MINI items M1 and M3 at baseline. Data were analyzed using a mixed model repeated measures approach, adjusted for baseline values of dependent measures.
On average, body weight and BMI increased over 6 months with lithium and quetiapine. However, those treated with quetiapine experienced greater increases from baseline in body weight (peak change, + 3.6 lbs. vs. + 1.4 lbs.) and BMI (peak change, + 0.6 kg/m vs. + 0.3 kg/m), starting at 2 weeks (group x time, F= 2.9, p = 0.003 for body weight, F= 3.0, p = 0.002 for BMI). Significant increases in waist circumference were observed only with quetiapine. The relationship between drug treatment and changes in body weight (group x time x binge eating status, F= 2.0, p = 0.002), BMI (F= 2.0, p = 0.002), and waist circumference (women only, F= 2.9, p < 0.0001) were moderated by BE behavior. The largest increases over 24 weeks in body weight and BMI, and waist circumference in women, occurred for quetiapine-treated patients with baseline binge-eating, relative to quetiapine-treated patients without binge eating and lithium-treated patients with or without baseline binge-eating.
Bipolar CHOICE was not designed to study anthropometric outcomes.
Greater changes in body weight, BMI, and waist circumference occurred with quetiapine- versus lithium-based treatment over 6 months of treatment. The effects of study drugs on these anthropometric measures were moderated by BE behavior at baseline.
锂盐和喹硫平都可能导致体重增加，但关于它们在长期的人体测量学影响，以及基线暴食行为（BE）的潜在调节作用，我们目前仍知之甚少。
我们评估了 482 名符合 DSM-IV 双相情感障碍诊断标准的成年人在接受锂盐和喹硫平对照有效性研究（Bipolar CHOICE）时，6 个月时的体重、体重指数（BMI）和腰围变化。基线时以及 2、4、6、8、12、16、20 和 24 周时，均进行人体测量学测量。BE 行为的定义为 MINI 项目 M1 和 M3 的阳性反应。采用混合模型重复测量方法分析数据，对依赖指标的基线值进行了调整。
平均而言，锂盐和喹硫平治疗后体重和 BMI 在 6 个月内增加。然而，与锂盐治疗组相比，喹硫平治疗组在体重（峰值变化，+3.6 磅 vs.+1.4 磅）和 BMI（峰值变化，+0.6 公斤/米 2 vs.+0.3 公斤/米 2）方面的基线增加更大，这种变化从 2 周时就开始出现（组间 x 时间，F=2.9，p=0.003 用于体重，F=3.0，p=0.002 用于 BMI）。仅在喹硫平治疗组观察到腰围的显著增加。药物治疗与体重变化（组间 x 时间 x 暴食行为状态，F=2.0，p=0.002）、BMI（F=2.0，p=0.002）和腰围（仅女性，F=2.9，p<0.0001）之间的关系受基线 BE 行为的调节。在 24 周内，体重和 BMI 以及女性腰围的最大增加发生在基线时即有暴食行为的喹硫平治疗患者，而不是无暴食行为的喹硫平治疗患者和有或无基线暴食行为的锂盐治疗患者。
Bipolar CHOICE 并非专门用于研究人体测量学结果。
在 6 个月的治疗期间，与锂盐相比，喹硫平治疗组在体重、BMI 和腰围方面的变化更大。在基线时 BE 行为调节了研究药物对这些人体测量指标的影响。
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