Rikhari Praveen, Kumar Ashutosh, Agrawal Prabhat, Kumar Harendra
Department of Psychiatry, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
J Family Med Prim Care. 2022 May;11(5):2194-2200. doi: 10.4103/jfmpc.jfmpc_2161_21. Epub 2022 May 14.
Schizophrenia spectrum and other psychotic disorders are common disorders often requiring long-term treatment with atypical antipsychotics, which might cause metabolic dysfunctions. We aimed to study the metabolic dysfunctions with olanzapine and risperidone in patients with schizophrenia spectrum and other psychotic disorders. We also explored the incidence of new-onset metabolic syndrome and its predictors.
This was a 24-week prospective observational study conducted at a teaching hospital in North India. The patients were prescribed olanzapine or risperidone. Anthropometric measurements (waist circumference, weight, body mass index, blood pressure) and biochemical investigations (triglycerides, high-density lipoproteins, fasting plasma glucose) were recorded at baseline and after 24 weeks. Metabolic syndrome was defined using the International Diabetes Federation definition. Statistical tests used were Fisher's exact test, paired t-test, unpaired t-test, and logistic regression.
A total of 45 patients, 30 on olanzapine and 15 on risperidone completed the study. Statistically significant changes occurred in all variables with olanzapine while with risperidone statistically significant changes occurred in all variables except waist circumference and fasting plasma glucose. Statistically greater changes in mean values between the two were noted only for high-density lipoprotein with olanzapine. 20% of patients developed metabolic syndrome with non-significant between drug differences. Baseline triglyceride predicted the development of the metabolic syndrome.
Olanzapine and risperidone cause metabolic derangements and statistically significant differences may not exist between them. Baseline triglyceride levels might predict subsequent metabolic syndrome.
精神分裂症谱系及其他精神病性障碍是常见疾病，常需使用非典型抗精神病药物进行长期治疗，而这些药物可能导致代谢功能障碍。我们旨在研究精神分裂症谱系及其他精神病性障碍患者使用奥氮平和利培酮后的代谢功能障碍。我们还探讨了新发代谢综合征的发生率及其预测因素。
这是一项在印度北部一家教学医院进行的为期24周的前瞻性观察性研究。患者被处方使用奥氮平或利培酮。在基线和24周后记录人体测量指标（腰围、体重、体重指数、血压）和生化检查指标（甘油三酯、高密度脂蛋白、空腹血糖）。代谢综合征采用国际糖尿病联盟的定义。使用的统计检验方法有Fisher精确检验、配对t检验、非配对t检验和逻辑回归。
共有45名患者完成了研究，其中30名使用奥氮平，15名使用利培酮。使用奥氮平后所有变量均发生了具有统计学意义的变化，而使用利培酮后，除腰围和空腹血糖外的所有变量均发生了具有统计学意义的变化。两者之间仅在奥氮平组的高密度脂蛋白平均值上观察到统计学上更大的变化。20%的患者出现了代谢综合征，药物之间差异无统计学意义。基线甘油三酯可预测代谢综合征的发生。
奥氮平和利培酮都会引起代谢紊乱，且两者之间可能不存在统计学上的显著差异。基线甘油三酯水平可能预测随后的代谢综合征。
