Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
Beijing Huilongguan Hospital and Peking University Huilongguan Clinical Medical School, Beijing, China.
Schizophr Bull. 2022 Jun 21;48(4):850-859. doi: 10.1093/schbul/sbac044.
Antipsychotic-induced weight gain is associated with alterations to the composition of the gut microbiota. The purpose of this study was to determine the effect of probiotics plus dietary fiber on antipsychotic-induced weight gain.
Two sequential, randomized clinical trials were conducted. In Study 1, 90 drug-naïve, first-episode schizophrenia patients were randomized to receive either olanzapine plus probiotics or olanzapine monotherapy for 12 weeks. In Study 2, 60 drug-naïve, first-episode schizophrenia patients were randomly assigned to receive either olanzapine plus probiotics and dietary fiber or olanzapine monotherapy for 12 weeks.
In Study 1, no significant differences in weight gain were observed between the two groups. The insulin resistance index (IRI) was lower in the olanzapine plus probiotics group compared with the olanzapine monotherapy group at week 12 (estimated mean difference, -0.65, [95% confidence interval (CI), -1.10 to -0.20]; p = .005). In Study 2, weight gain was lower in the probiotics plus dietary fiber group than in the olanzapine monotherapy group at week 12 (estimated mean difference -3.45 kg, [95% CI, -5.91 to -1.00]; p = .007). At week 12, IRI increased significantly in the olanzapine monotherapy group (mean, 1.74; standard deviation (SD) = 1.11, p < .001), but not in the olanzapine plus probiotics and dietary fiber group (mean 0.47, SD = 2.16, p = .35) with an estimated mean difference of -0.95 between the two groups [95% CI, -1.77 to -0.14]; p = .022).
These results provide support for the efficacy and safety of probiotics plus dietary fiber in attenuating antipsychotic-induced weight gain in drug-naïve, first-episode schizophrenia patients.
抗精神病药引起的体重增加与肠道微生物群组成的改变有关。本研究旨在确定益生菌加膳食纤维对抗精神病药引起的体重增加的影响。
进行了两项连续的随机临床试验。在研究 1 中，90 名未经药物治疗的首发精神分裂症患者被随机分为奥氮平加益生菌组或奥氮平单药治疗组，疗程 12 周。在研究 2 中，60 名未经药物治疗的首发精神分裂症患者被随机分为奥氮平加益生菌和膳食纤维组或奥氮平单药治疗组，疗程 12 周。
在研究 1 中，两组体重增加无显著差异。在第 12 周时，奥氮平加益生菌组的胰岛素抵抗指数（IRI）低于奥氮平单药治疗组（估计平均差异，-0.65 [95%置信区间（CI），-1.10 至-0.20]；p =.005）。在研究 2 中，在第 12 周时，益生菌加膳食纤维组的体重增加低于奥氮平单药治疗组（估计平均差异-3.45 公斤，[95%CI，-5.91 至-1.00]；p =.007）。在第 12 周时，奥氮平单药治疗组的 IRI 显著增加（平均 1.74；标准差（SD）= 1.11，p <.001），但奥氮平加益生菌和膳食纤维组没有增加（平均 0.47，SD = 2.16，p =.35），两组间估计平均差异为-0.95 [95%CI，-1.77 至-0.14]；p =.022）。
这些结果为益生菌加膳食纤维在减轻未经药物治疗的首发精神分裂症患者抗精神病药引起的体重增加的疗效和安全性提供了支持。
