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精神科住院患者样本中肥胖、代谢综合征、糖尿病的患病率及心血管疾病风险:精神病学代谢(MiP)研究结果

Prevalence of obesity, metabolic syndrome, diabetes and risk of cardiovascular disease in a psychiatric inpatient sample: results of the Metabolism in Psychiatry (MiP) Study.

作者信息

Barton Barbara B, Zagler Anja, Engl Katharina, Rihs Leonie, Musil Richard

机构信息

Department of Psychiatry and Psychotherapy, University Hospital , LMU Munich, Germany, Nußbaumstraße 7, 80336, Munich, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2020 Aug;270(5):597-609. doi: 10.1007/s00406-019-01043-8. Epub 2019 Jul 13.

Abstract

The information on prevalence of obesity, diabetes, metabolic syndrome (MetS) and cardiovascular risk (CVR) and on sociodemographic variables available in patients with psychiatric diseases about to be treated with weight gain-associated medication (e.g., clozapine, mirtazapine, quetiapine) is limited. In a naturalistic study, psychiatric inpatients (age: 18-75) of all F diagnoses according to ICD-10, who were about to be treated with weight gain-associated medication, were included. Demographic variables were assessed as well as biological parameters to calculate the Body Mass Index (BMI), MetS, diabetes and CVR. A total of 163 inpatients were included (60.1% male; mean age: 39.8 (± 15.1, 18-75 years). The three most common disorders were depression (46.0%), bipolar disorder (20.9%) and drug addiction (20.2%). The three most common pharmacotherapeutic agents prescribed were quetiapine (29.4%), mirtazapine (20.9%) and risperidone (12.9%). Of the included inpatients 30.1% were overweight, 17.2% obese, and 26.9% and 22.4% fulfilled the criteria for a MetS according to the International Diabetes Federation (IDF) and the National Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP ATP III), respectively, 3.8% had (pre)diabetes and 8.3% had a moderate and 1.9% a high CVR according to the Prospective Cardiovascular Münster (PROCAM) score. Detailed information is reported on all assessed parameters as well as on subgroup analyses concerning sociodemographic variables. The results suggest that psychiatric patients suffer from multiple metabolic disturbances in comparison to the general population. Monitoring weight, waist circumference, blood pressure and cholesterol regularly is, therefore, highly relevant.

摘要

关于即将接受与体重增加相关药物(如氯氮平、米氮平、喹硫平)治疗的精神疾病患者中肥胖、糖尿病、代谢综合征(MetS)和心血管风险(CVR)的患病率以及社会人口学变量的信息有限。在一项自然主义研究中,纳入了根据ICD - 10诊断为所有F类别的、即将接受与体重增加相关药物治疗的18至75岁精神科住院患者。评估了人口统计学变量以及用于计算体重指数(BMI)、MetS、糖尿病和CVR的生物学参数。总共纳入了163名住院患者(男性占60.1%;平均年龄:39.8(±15.1,18 - 75岁)。三种最常见的疾病是抑郁症(46.0%)、双相情感障碍(20.9%)和药物成瘾(20.2%)。三种最常用的药物治疗药物是喹硫平(29.4%)、米氮平(20.9%)和利培酮(12.9%)。在所纳入的住院患者中,30.1%超重,17.2%肥胖,分别有26.9%和22.4%根据国际糖尿病联盟(IDF)和美国国家胆固醇教育计划成人治疗专家组第三次报告(NCEP ATP III)符合MetS标准,3.8%患有(预)糖尿病,根据明斯特前瞻性心血管研究(PROCAM)评分,8.3%有中度CVR,1.9%有高度CVR。报告了所有评估参数以及关于社会人口学变量的亚组分析的详细信息。结果表明,与一般人群相比,精神科患者存在多种代谢紊乱。因此,定期监测体重、腰围、血压和胆固醇非常重要。

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