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ω-3 脂肪酸可降低抗精神病药物治疗首发精神分裂症患者的心脏代谢风险:来自 OFFER 随机对照研究的结果。

Omega-3 fatty acids reduce cardiometabolic risk in first-episode schizophrenia patients treated with antipsychotics: Findings from the OFFER randomized controlled study.

机构信息

Department of Affective and Psychotic Disorders, Medical University of Lodz, ul. Czechoslowacka 8/10, 92-216 Lodz, Poland.

Child and Adolescent Psychiatry Unit, Central Teaching Hospital, Medical University of Lodz, ul. Pomorska 251, 92-213 Lodz, Poland.

出版信息

Schizophr Res. 2021 Apr;230:61-68. doi: 10.1016/j.schres.2021.02.012. Epub 2021 Mar 5.

Abstract

UNLABELLED

Metabolic syndrome (MetS) increases the risk of premature mortality observed in schizophrenia (SCZ). N-3 polyunsaturated fatty acid (PUFA) deficiency has been reported in different stages of schizophrenia. N-3 PUFA supplementation was found to be beneficial in both chronic SCZ and MetS. No intervention studies based on n-3 PUFA as add-on therapy to antipsychotics have examined the changes in MetS risk in first-episode schizophrenia.

AIM

This randomized placebo-controlled trial assesses the effect of a 26-week intervention composed of either 2.2 g/day of n-3 PUFA or olive oil placebo on the frequency of MetS and the changes in its constituents as a secondary outcome measure.

METHODS

Seventy-one adult inpatients diagnosed with first-episode schizophrenia were randomly assigned to study groups. The active intervention used a 3:2 mixture of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. Metabolic syndrome components were monitored throughout the study.

RESULTS

A significant reduction in the frequency of MetS was observed in the EPA + DHA group (p = 0.0408); as well as some specific MetS components: e.g., a decrease in fasting blood glucose (p = 0.045). The beneficial effects of EPA + DHA were even more pronounced in patients treated mainly with olanzapine, e.g. significant reductions of total cholesterol (p = 0.037) and blood glucose levels (p = 0.034). Significant positive correlations were found between the general psychopathology subscale of PANSS (primary outcome) and triglyceride level changes.

CONCLUSION

N-3 PUFA supplementation in early SCZ may constitute a safe and affordable intervention that can reduce the risk of MetS and its lethal complications.

摘要

目的

本随机安慰剂对照试验评估了为期 26 周的干预措施的效果,该干预措施由 2.2g/天的 n-3 多不饱和脂肪酸(PUFA)或橄榄油安慰剂组成,作为次要结局指标,评估其对代谢综合征(MetS)频率的影响以及其成分的变化。

方法

71 名被诊断为首发精神分裂症的成年住院患者被随机分配到研究组。活性干预使用了二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)的 3:2 混合物。在整个研究过程中监测代谢综合征的成分。

结果

在 EPA+DHA 组中,MetS 的发生频率显著降低(p=0.0408);以及一些特定的 MetS 成分,如空腹血糖降低(p=0.045)。EPA+DHA 的有益效果在主要用奥氮平治疗的患者中更为明显,例如总胆固醇(p=0.037)和血糖水平(p=0.034)显著降低。PANSS(主要结局)的一般精神病学分量表与甘油三酯水平变化之间存在显著的正相关。

结论

在早期精神分裂症中补充 n-3 PUFA 可能构成一种安全且经济实惠的干预措施,可以降低 MetS 及其致命并发症的风险。

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