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一项关于精神分裂症住院患者与心境障碍住院患者代谢异同的横断面研究。

A cross-sectional study on metabolic similarities and differences between inpatients with schizophrenia and those with mood disorders.

作者信息

Uju Yoriyasu, Kanzaki Tetsuto, Yamasaki Yuki, Kondo Tadayuki, Nanasawa Hideki, Takeuchi Yu, Yanagisawa Yuta, Kusanishi Shun, Nakano Chieko, Enomoto Tetsuro, Sako Akahito, Yanai Hidekazu, Mishima Shunichi, Mimori Seisuke, Igarashi Kazuei, Takizawa Tsuyoshi, Hayakawa Tatsuro

机构信息

Department of Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, 1-7-1, Kohnodai, Ichikawa, Japan.

Department of Drug Informatics, Graduate School and Faculty of Pharmaceutical Sciences, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, Japan.

出版信息

Ann Gen Psychiatry. 2020 Sep 22;19:53. doi: 10.1186/s12991-020-00303-5. eCollection 2020.

Abstract

BACKGROUND

One of the main causes of death in psychiatric patients is cardiovascular diseases which are closely related with lifestyle-related diseases. Psychiatric disorders include schizophrenia and mood disorders, whose symptoms and treatment medicines are different, suggesting that they might have different metabolic disorders. Thus, we studied the differences of lifestyle-related diseases between schizophrenia and mood disorders in Japan.

METHODS

This cross-sectional study was performed from 2015 to 2017. Study participants were 189 Japanese hospitalized patients (144 schizophrenia group, 45 mood disorders group) in the department of psychiatry at Kohnodai hospital. We examined physical disorders, metabolic status of glucose and lipid, estimated glomerular filtration rate (eGFR) and brain magnetic resonance imaging. We compared these data between schizophrenia and mood disorders groups using analysis of covariance or logistic regression analysis. In comparisons between inpatients with schizophrenia or mood disorders group and the standard, we quoted 'The National Health and Nutrition Survey in Japan 2015' by Ministry of Health, Labor and Welfare as the standard.

RESULTS

eGFR and prevalence of smoking were significantly lower in patients with mood disorder group than those with schizophrenia group by adjustment for age. In comparisons between patients with schizophrenia group or mood disorders group and each standard, the ratio of silent brain infarction (SBI) and cerebral infarction were significantly high in both groups. Schizophrenia group showed significantly higher prevalence of diabetes, low high-density lipoprotein (HDL) cholesterolemia, metabolic syndrome and smoking than the standard. Mood disorders group had significantly high prevalence of low HDL-cholesterolemia compared with the standard. Fasting blood glucose and HbA1c were significantly higher in schizophrenia group and female mood disorders group than the standard. Female mood disorders group had significantly decreased eGFR with increased ratio of eGFR < 60 ml/min than the standard.

CONCLUSIONS

Participants of both groups had increased ratio of SBI and cerebral infarction, accompanied with glucose and lipid disorders. Compared with schizophrenia group, mood disorders group showed significantly low eGFR and prevalence of smoking.

摘要

背景

心血管疾病是精神科患者的主要死因之一,与生活方式相关疾病密切相关。精神障碍包括精神分裂症和情绪障碍,其症状和治疗药物不同,提示它们可能存在不同的代谢紊乱。因此,我们研究了日本精神分裂症和情绪障碍患者生活方式相关疾病的差异。

方法

本横断面研究于2015年至2017年进行。研究对象为小田代医院精神科189名日本住院患者(精神分裂症组144例,情绪障碍组45例)。我们检查了身体疾病、血糖和血脂代谢状况、估计肾小球滤过率(eGFR)和脑磁共振成像。我们使用协方差分析或逻辑回归分析比较了精神分裂症组和情绪障碍组之间的这些数据。在精神分裂症或情绪障碍组住院患者与标准之间的比较中,我们引用了厚生劳动省的《2015年日本国民健康与营养调查》作为标准。

结果

经年龄调整后,情绪障碍组患者的eGFR和吸烟率显著低于精神分裂症组。在精神分裂症组或情绪障碍组患者与各自标准的比较中,两组的无症状脑梗死(SBI)和脑梗死比例均显著较高。精神分裂症组的糖尿病、低高密度脂蛋白(HDL)胆固醇血症、代谢综合征和吸烟患病率显著高于标准。与标准相比,情绪障碍组的低HDL胆固醇血症患病率显著较高。精神分裂症组和女性情绪障碍组的空腹血糖和糖化血红蛋白(HbA1c)显著高于标准。女性情绪障碍组的eGFR显著降低,eGFR<60 ml/min的比例高于标准。

结论

两组参与者的SBI和脑梗死比例均增加,伴有糖脂紊乱。与精神分裂症组相比,情绪障碍组的eGFR和吸烟率显著较低。

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