Brain and Mind Centre, 4334University of Sydney, Camperdown, NSW, Australia.
Australas Psychiatry. 2022 Dec;30(6):689-693. doi: 10.1177/10398562221115607. Epub 2022 Jul 19.
Youth with early-onset mood or psychotic disorders are occasionally prescribed metformin to manage cardiometabolic risk. This retrospective study explores the demographic, clinical and metabolic factors associated with metformin prescription youth with mood or psychotic disorders.
Participants included 72 youth with mood or psychotic disorders from a young adult mental health inpatient unit, of which 18 (33%) were newly prescribed metformin, and 54 (66%) were not prescribed metformin. Demographic and clinical information were extracted from the patients' medical files along with body mass index (BMI), fasting serum bloods and calculated updated homeostatic model of insulin resistance assessment (HOMA2-IR) scores to compare profiles between groups.
Of those prescribed metformin, 83% were overweight or obese and 72% had elevated HOMA2-IR scores. Of those not receiving metformin treatment, 41% were overweight or obese and 22% had elevated HOMA2-IR scores. Youth prescribed metformin had significantly higher BMI, and elevated markers of insulin resistance, but did not differ to those not prescribed metformin on other demographic, clinical or metabolic factors.
While metformin is prescribed to some youth with mood or psychotic disorders displaying markers of cardiometabolic disturbance, there is a need to develop clearer treatment guidelines for metformin in these youth.
患有早发性心境或精神病性障碍的年轻人有时会被开具二甲双胍来管理心血管代谢风险。本回顾性研究探讨了与心境或精神病性障碍青年开具二甲双胍处方相关的人口统计学、临床和代谢因素。
参与者包括来自青年精神科住院病房的 72 名患有心境或精神病性障碍的年轻人，其中 18 名（33%）新开具了二甲双胍，54 名（66%）未开具二甲双胍。从患者的病历中提取人口统计学和临床信息，以及体重指数（BMI）、空腹血清血液和计算得出的稳态模型评估的胰岛素抵抗更新评估（HOMA2-IR）评分，以比较组间的特征。
在开具二甲双胍的患者中，83%超重或肥胖，72%的 HOMA2-IR 评分升高。未接受二甲双胍治疗的患者中，41%超重或肥胖，22%的 HOMA2-IR 评分升高。开具二甲双胍的年轻人的 BMI 显著更高，且胰岛素抵抗标志物升高，但在其他人口统计学、临床或代谢因素方面与未开具二甲双胍的患者无差异。
虽然有些患有心境或精神病性障碍且有心血管代谢紊乱迹象的年轻人会被开具二甲双胍，但需要为这些年轻人制定更明确的二甲双胍治疗指南。
