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接受导致代谢紊乱的精神药物治疗的精神科人群中血浆咖啡因及其他甲基黄嘌呤与代谢参数之间的关联

Association Between Plasma Caffeine and Other Methylxanthines and Metabolic Parameters in a Psychiatric Population Treated With Psychotropic Drugs Inducing Metabolic Disturbances.

作者信息

Delacrétaz Aurélie, Vandenberghe Frederik, Glatard Anaïs, Levier Axel, Dubath Céline, Ansermot Nicolas, Crettol Séverine, Gholam-Rezaee Mehdi, Guessous Idris, Bochud Murielle, von Gunten Armin, Conus Philippe, Eap Chin B

机构信息

Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, University of Lausanne, Lausanne, Switzerland.

Centre of Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, Prilly, University of Lausanne, Lausanne, Switzerland.

出版信息

Front Psychiatry. 2018 Nov 9;9:573. doi: 10.3389/fpsyt.2018.00573. eCollection 2018.

Abstract

Multiple studies conducted in the general population identified an association between self-reported coffee consumption and plasma lipid levels. To date, no study assessed whether and which plasma methylxanthines (caffeine and/or its metabolites, i.e., paraxanthine, theophylline, and theobromine) are associated with plasma lipids. In psychiatric patients, an important coffee consumption is often reported and many psychotropic drugs can induce a rapid and substantial increase of plasma lipid levels. To determine whether plasma methylxanthines are associated with metabolic parameters in psychiatric patients receiving treatments known to induce metabolic disturbances. Data were obtained from a prospective study including 630 patients with metabolic parameters [i.e., body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and fasting triglycerides (TG)] monitored routinely during psychotropic treatment. Plasma methylxanthines levels. Metabolic variables including BMI and plasma lipid levels. Multivariate analyses indicated that BMI, TC, HDL-C, and non-HDL-C increased significantly with increasing total methylxanthines ( ≤ 0.05). In addition, compared to patients with plasma caffeine concentration in the lowest quartile, those with caffeine concentration in the highest quartile were twice more prone to suffer from non-HDL hypercholesterolemia ( = 0.05), five times more likely to suffer from hypertriglyceridemia ( = 0.01) and four times more susceptible to be overweight ( = 0.01). This study showed that plasma caffeine and other methylxanthines are associated with worsening of metabolic parameters in patients receiving psychotropic treatments known to induce metabolic disturbances. It emphasizes that important caffeine consumption could be considered as an additional environmental risk factor for metabolic worsening in patients receiving such treatments.

摘要

在普通人群中进行的多项研究发现,自我报告的咖啡摄入量与血浆脂质水平之间存在关联。迄今为止,尚无研究评估血浆甲基黄嘌呤(咖啡因和/或其代谢产物,即副黄嘌呤、茶碱和可可碱)是否以及哪些与血浆脂质有关。在精神病患者中,经常有大量咖啡摄入的报道,而且许多精神药物会导致血浆脂质水平迅速大幅升高。为了确定血浆甲基黄嘌呤是否与接受已知会引起代谢紊乱治疗的精神病患者的代谢参数有关。数据来自一项前瞻性研究,该研究纳入了630名在精神药物治疗期间常规监测代谢参数的患者[即体重指数(BMI)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(非HDL-C)和空腹甘油三酯(TG)]。血浆甲基黄嘌呤水平。代谢变量包括BMI和血浆脂质水平。多变量分析表明,BMI、TC、HDL-C和非HDL-C随着总甲基黄嘌呤的增加而显著升高(P≤0.05)。此外,与血浆咖啡因浓度处于最低四分位数的患者相比,咖啡因浓度处于最高四分位数的患者患非HDL高胆固醇血症的可能性高出两倍(P = 0.05),患高甘油三酯血症的可能性高出五倍(P = 0.01),超重的易感性高出四倍(P = 0.01)。这项研究表明,血浆咖啡因和其他甲基黄嘌呤与接受已知会引起代谢紊乱治疗的患者的代谢参数恶化有关。它强调,大量的咖啡因摄入可被视为接受此类治疗患者代谢恶化的一个额外环境风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ad2/6238296/bbf8adad0466/fpsyt-09-00573-g0001.jpg

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