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首发未用药精神分裂症患者代谢紊乱模式的性别差异。

Sex differences in metabolic disorder patterns of first-episode drug-naive patients with schizophrenia.

机构信息

Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.

Qingdao Mental Health Center, Qingdao University, Qingdao, China.

出版信息

Psychoneuroendocrinology. 2021 Feb;124:105061. doi: 10.1016/j.psyneuen.2020.105061. Epub 2020 Nov 16.

Abstract

Although metabolic disorders are common in schizophrenia, few studies investigated sex differences in metabolic disorder. This study aimed to examine the sex differences in the clinical correlates of metabolic disorders and MetS in patients with first-episode drug-naïve (FEDN) schizophrenia. A total of 257 FEDN schizophrenia patients and 118 controls were recruited. Body mass index (BMI), waist circumference (WC) and blood pressure were measured. Fasting blood samples were drawn to detect triglycerides, cholesterol, high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), blood glucose, glycosylated hemoglobin (HbA1c) and insulin. The Positive and Negative Syndrome Scale (PANSS) was applied to assess the clinical symptoms. There was sex difference in the prevalence of high BMI and dyslipidemia of schizophrenia patients. Female patients had lower prevalence of high BMI (p = 0.03) and hypertriglyceridemia (p = 0.006), but had higher prevalence of hypo-HDLC (p = 0.005), compared with male patients. Further, there were sex differences in the relationship between metabolic parameters and psychopathological dimensions. In male patients, WC was associated with positive symptoms and negative symptoms (r = 0.26, p = 0.02; r = 0.26, p = 0.02). In female patients, BMI (r = 0.26, p = 0.01), WC (r = 0.30, p = 0.004) and HAb1c were associated with positive symptoms (r = 0.27, p = 0.008). Insulin (r = 0.24, p = 0.02; r = 0.23, p = 0.04) and HOMA-IR (r = 0.29, p = 0.004; r = 0.25, p = 0.02) were associated with positive symptoms and general psychopathology symptoms. The contribution of clinical and metabolic components to MetS was almost same between male and female patients. Our study demonstrates sex difference in metabolic disorder patterns in schizophrenia patients.

摘要

虽然代谢紊乱在精神分裂症中很常见,但很少有研究调查代谢紊乱的性别差异。本研究旨在探讨首发未经药物治疗的精神分裂症(FEDN)患者代谢障碍和代谢综合征(MetS)的临床相关性中的性别差异。共招募了 257 名 FEDN 精神分裂症患者和 118 名对照者。测量了体重指数(BMI)、腰围(WC)和血压。抽取空腹血样检测甘油三酯、胆固醇、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、血糖、糖化血红蛋白(HbA1c)和胰岛素。应用阳性和阴性症状量表(PANSS)评估临床症状。精神分裂症患者的 BMI 升高和血脂异常的患病率存在性别差异。与男性患者相比,女性患者 BMI 升高(p = 0.03)和高甘油三酯血症(p = 0.006)的患病率较低,但低 HDLC 血症(p = 0.005)的患病率较高。此外,代谢参数与精神病理学维度之间的关系存在性别差异。在男性患者中,WC 与阳性症状和阴性症状相关(r = 0.26,p = 0.02;r = 0.26,p = 0.02)。在女性患者中,BMI(r = 0.26,p = 0.01)、WC(r = 0.30,p = 0.004)和 HAb1c 与阳性症状相关(r = 0.27,p = 0.008)。胰岛素(r = 0.24,p = 0.02;r = 0.23,p = 0.04)和 HOMA-IR(r = 0.29,p = 0.004;r = 0.25,p = 0.02)与阳性症状和一般精神病理学症状相关。临床和代谢成分对 MetS 的贡献在男性和女性患者之间几乎相同。我们的研究表明,精神分裂症患者的代谢紊乱模式存在性别差异。

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