Andrade Chittaranjan
Professor of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Psychol Med. 2020 Apr 25;42(3):316-317. doi: 10.4103/IJPSYM.IJPSYM_178_20. eCollection 2020 May-Jun.
Patients with major mental illness and especially those who receive antipsychotic drugs are at increased risk of metabolic syndrome. Dyslipidemia is part of the metabolic syndrome. Dyslipidemia is associated with an increased risk of cardiovascular, cerebrovascular, and other diseases. A fasting lipid profile is traditionally ordered to determine the need for and to monitor lipid-lowering treatment. However, a recent study showed that fasting and nonfasting lipid levels, obtained from the same patients, almost identically predicted hard 3-year cardiovascular event risks; the risks with fasting and nonfasting levels were closely similar in various secondary analyses, as well. This supports the stance of major medical associations in the field to accept nonfasting lipid levels to guide the treatment of dyslipidemia in the primary and secondary prevention of cardiovascular and cerebrovascular disease events.
患有严重精神疾病的患者,尤其是那些接受抗精神病药物治疗的患者,患代谢综合征的风险会增加。血脂异常是代谢综合征的一部分。血脂异常与心血管疾病、脑血管疾病和其他疾病的风险增加有关。传统上会进行空腹血脂检查,以确定是否需要进行降脂治疗以及监测降脂治疗情况。然而,最近一项研究表明,从同一患者身上获得的空腹和非空腹血脂水平几乎能同样准确地预测3年内发生严重心血管事件的风险;在各种二次分析中,空腹和非空腹血脂水平所对应的风险也非常相似。这支持了该领域主要医学协会的立场,即接受非空腹血脂水平来指导在心血管和脑血管疾病事件的一级和二级预防中血脂异常的治疗。