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中国慢性精神分裂症患者的肥胖症:患病率、临床相关性及与认知缺陷的关系。

Obesity in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates and relationship with cognitive deficits.

机构信息

CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.

Departtment of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, Jiangxi Province, China.

出版信息

Schizophr Res. 2020 Jan;215:270-276. doi: 10.1016/j.schres.2019.10.017. Epub 2019 Oct 22.

Abstract

The prevalence of obesity in schizophrenia patients is high, especially in chronic and medicated patients. Few studies have explored the relationships between obesity, cognition and clinical correlates in patients with schizophrenia. This study was designed to assess the prevalence and clinical correlates of obesity and its relationship to cognitive impairment in Chinese patients with schizophrenia. We recruited 633 inpatients and collected clinical, demographic data and lipid parameters. The Positive and Negative Syndrome Scale (PANSS) and its five-factor model were adopted for psychopathological symptoms. The prevalence of comorbid obesity in schizophrenia patients was 16.4%. The plasma levels of glucose, triglyceride, low density lipoprotein (LDL), apolipoprotein B, and cholesterol were higher, but high density lipoprotein (HDL) levels were lower in obese patients than those in non-obese patients (all p < 0.05). Furthermore, obese patients had lower PANSS negative symptom, cognitive factor and total scores than non-obese patients (all p < 0.05). Correlation analysis showed a significant correlation between BMI and the following variables: age, marriage, gender, negative symptoms, general psychopathological symptoms, cognitive factor, PANSS total score, glucose, triglycerides, HDL, LDL, cholesterol and apolipoprotein B (all p < 0.05). Further multiple regression showed that PANSS cognitive factor, PANSS total score, and triglyceride were important independent predictors of obesity. Our results indicate a high prevalence of obesity in Chinese patients with chronic schizophrenia. Multiple demographics, clinical variables, and lipid parameters are associated with obesity in schizophrenia. Moreover, obesity appears to be a protective factor for psychological symptoms. However, not having objective assessments for cognition in this study is a limitation.

摘要

精神分裂症患者肥胖的患病率很高,尤其是在慢性和用药的患者中。很少有研究探讨肥胖、认知与精神分裂症患者临床相关性之间的关系。本研究旨在评估肥胖的患病率和临床相关性及其与中国精神分裂症患者认知障碍的关系。我们招募了 633 名住院患者,并收集了临床、人口统计学数据和血脂参数。采用阳性和阴性症状量表(PANSS)及其五因素模型评估精神病理症状。精神分裂症患者合并肥胖的患病率为 16.4%。与非肥胖患者相比,肥胖患者的血糖、甘油三酯、低密度脂蛋白(LDL)、载脂蛋白 B 和胆固醇水平较高,而高密度脂蛋白(HDL)水平较低(均 p < 0.05)。此外,与非肥胖患者相比,肥胖患者的 PANSS 阴性症状、认知因子和总分较低(均 p < 0.05)。相关性分析显示,BMI 与以下变量之间存在显著相关性:年龄、婚姻、性别、阴性症状、一般精神病理症状、认知因子、PANSS 总分、血糖、甘油三酯、HDL、LDL、胆固醇和载脂蛋白 B(均 p < 0.05)。进一步的多元回归显示,PANSS 认知因子、PANSS 总分和甘油三酯是肥胖的重要独立预测因子。我们的研究结果表明,中国慢性精神分裂症患者肥胖的患病率很高。多种人口统计学、临床变量和血脂参数与精神分裂症患者的肥胖有关。此外,肥胖似乎是心理症状的保护因素。然而,本研究没有对认知进行客观评估,这是一个局限性。

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