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代谢参数与首发精神病病程的关系——初步研究。

Relationship of metabolic parameters with the course of the first episode of psychosis - preliminary research.

机构信息

Uniwersytet Jagielloński Collegium Medicum, Wydział Lekarski, Katedra Psychiatrii, Klinika Psychiatrii Dzieci i Młodzieży, Kraków, Polska.

Uniwersytet Jagielloński Collegium Medicum, Wydział Farmaceutyczny, Zakład Diagnostyki Medycznej, Kraków, Polska.

出版信息

Psychiatr Pol. 2021 Jun 30;55(3):525-540. doi: 10.12740/PP/119021.

Abstract

OBJECTIVES

Cardiometabolic syndromes are the most common causes of complications shortening life expectancy in patients treated for mental disorders, especially schizophrenia. However, how much cardiometabolic risk is related to lifestyle, side-effects of treatment or psychosis is not clear. The aim of this study was a prospective assessment of metabolic changes in young, initially somatically healthy patients diagnosed with the first acute episode of psychosis with no prior pharmacological treatment.

METHODS

The study involved 15 young patients (average age of 19.95 ± 6.88 years). Analyses (laboratory and clinical) were performed at the time of admission and after 3 and 12 weeks and included morphology, lipid profile, glucose, inflammation markers, blood pressure (BP), and body mass index (BMI). The severity of clinical symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS), and the cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA). The duration of untreated psychosis (DUP) was also measured.

RESULTS

There was a significant increase in BMI, dyslipidemia, inflammation, and systolic blood pressure after 12 weeks from the start of the treatment, while cortisol level decreased. A negative correlation was observed between PANSS-P (PANSS positivescale) measurements and total cholesterol, PANSS total and low-density lipoprotein, as well as DUPand MoCA. High-density lipoprotein (HDL) correlated positively with DUP, cortisol, monocytes, and white blood cells in the first week.

CONCLUSIONS

The results of the study indicate a relationship between the development and treatment of the first acute episode of psychosis and the results of laboratory tests that are indicators of the development of metabolic stress in patients.

摘要

目的

代谢综合征是精神障碍患者治疗过程中导致并发症、缩短预期寿命的最常见原因,尤其是精神分裂症患者。然而,心血管代谢风险与生活方式、治疗副作用或精神病之间有多少关联尚不清楚。本研究的目的是前瞻性评估最初患有未经药物治疗的首发急性精神病的年轻、躯体健康患者的代谢变化。

方法

该研究纳入了 15 名年轻患者(平均年龄 19.95±6.88 岁)。在入院时以及治疗后 3 周和 12 周进行分析(实验室和临床),包括形态学、血脂谱、血糖、炎症标志物、血压(BP)和体重指数(BMI)。使用阳性和阴性综合征量表(PANSS)评估临床症状严重程度,使用蒙特利尔认知评估(MoCA)评估认知功能。还测量了未治疗精神病持续时间(DUP)。

结果

从治疗开始后 12 周,BMI、血脂异常、炎症和收缩压显著增加,而皮质醇水平下降。PANSS-P(PANSS 阳性量表)测量值与总胆固醇、PANSS 总分和低密度脂蛋白以及 DUP 和 MoCA 呈负相关。高密度脂蛋白(HDL)与 DUP、皮质醇、单核细胞和白细胞在第一周呈正相关。

结论

研究结果表明,首发急性精神病的发生和治疗与实验室检查结果之间存在关联,这些结果是患者代谢应激发展的指标。

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