Koricanac Aleksandra, Tomic Lucic Aleksandra, Veselinovic Mirjana, Bazic Sretenovic Danijela, Bucic Gorica, Azanjac Anja, Radmanovic Olivera, Matovic Mirjana, Stanojevic Marijana, Jurisic Skevin Aleksandra, Simovic Markovic Bojana, Pantic Jelena, Arsenijevic Nebojša, Radosavljevic Gordana D, Nikolic Maja, Zornic Nenad, Nesic Jelena, Muric Nemanja, Radmanovic Branimir
Department of Internal Medicine, General Hospital Kraljevo, Kraljevo, Serbia.
Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Front Psychiatry. 2022 Jul 25;13:925757. doi: 10.3389/fpsyt.2022.925757. eCollection 2022.
Many studies so far have shown that antipsychotic therapy may have an effect on the development of metabolic syndrome in patients diagnosed with schizophrenia. Our goal was to determine whether our respondents are at risk for developing metabolic syndrome and who is more predisposed to it.
In a stable phase, 60 patients diagnosed with schizophrenia were equally divided into three groups according to the drug (risperidone, clozapine, and aripiprazole monotherapy). Control group had 20 healthy examinees. Patients were evaluated first using The Positive and Negative Syndrome Scale (PANSS). Prolactin, lipid status, glycemia, insulin, cytokine values (IL-33, TGF-β, and TNF-α) and C-reactive protein (CRP) were measured. Also, Body mass index (BMI), Homeostatic Model Assesment for Insulin Resistance (HOMA index), waist and hip circumference (WHR) and blood pressure (TA) measurement were performed in the study.
Patients treated with risperidone compared to healthy control subjects and aripiprazol group of patients had statistically significant difference in prolactin levels. In clozapine group compared to healthy control group values of HDL cholesterol and glucose level were statistically significant different. In aripiprazole group compared to healthy control group value of BMI was statistically significant different. Statistically significant correlations were found in TNF-α with glucose and HOMA index in risperidone treated patients and with BMI in clozapine group of patients; IL-33 with glucose in risperidone and with BMI in clozapine group of patients and TGF-β with glucose in risperidone group, with insulin and HOMA index in clozapine group and statistically significant negative correlation with LDL cholesterol in aripiprazole group of patients.
Patients on risperidone and clozapine therapy may be at greater risk of developing metabolic syndrome than patients treated with aripiprazole. Statistically significant difference in concentration of TNF-α and TGF-β was in the group of patients treated with risperidone compared to healthy control group.
迄今为止，许多研究表明抗精神病药物治疗可能会对被诊断为精神分裂症的患者代谢综合征的发展产生影响。我们的目标是确定我们的受访者是否有患代谢综合征的风险，以及谁更容易患此病。
在稳定期，60名被诊断为精神分裂症的患者根据药物（利培酮、氯氮平和阿立哌唑单药治疗）平均分为三组。对照组有20名健康受试者。首先使用阳性和阴性症状量表（PANSS）对患者进行评估。测量催乳素、血脂状况、血糖、胰岛素、细胞因子值（IL-33、TGF-β和TNF-α）以及C反应蛋白（CRP）。此外，在研究中还进行了体重指数（BMI）、胰岛素抵抗稳态模型评估（HOMA指数）、腰围和臀围（腰臀比）以及血压（TA）测量。
与健康对照组和阿立哌唑组患者相比，接受利培酮治疗的患者催乳素水平有统计学显著差异。与健康对照组相比，氯氮平组的高密度脂蛋白胆固醇和血糖水平值有统计学显著差异。与健康对照组相比，阿立哌唑组的BMI值有统计学显著差异。在接受利培酮治疗的患者中，TNF-α与血糖和HOMA指数之间以及在氯氮平组患者中与BMI之间存在统计学显著相关性；在利培酮组中IL-33与血糖以及在氯氮平组患者中与BMI之间存在相关性，在利培酮组中TGF-β与血糖、在氯氮平组中与胰岛素和HOMA指数存在相关性，在阿立哌唑组患者中与低密度脂蛋白胆固醇存在统计学显著负相关。
与接受阿立哌唑治疗的患者相比，接受利培酮和氯氮平治疗的患者患代谢综合征的风险可能更高。与健康对照组相比，接受利培酮治疗的患者组中TNF-α和TGF-β浓度存在统计学显著差异。
