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长期住院精神分裂症患者非酒精性脂肪性肝病的患病率及影响因素:一项横断面回顾性研究

Prevalence and Influence Factors for Non-Alcoholic Fatty Liver Disease in Long-Term Hospitalized Patients with Schizophrenia: A Cross-Sectional Retrospective Study.

作者信息

Li Xuelong, Gao Yakun, Wang Yongmei, Wang Ying, Wu Qing

机构信息

School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, People's Republic of China.

Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2023 Feb 18;19:379-389. doi: 10.2147/NDT.S398385. eCollection 2023.

Abstract

PURPOSE

Long-term hospitalized patients with schizophrenia (SCZ) are vulnerable to physical illness, leading to impaired life expectancy and treatment outcomes. There are few studies on the influence of non-alcoholic fatty liver disease (NAFLD) in long-term hospitalized patients. This study aimed to investigate the prevalence of and influence factors for NAFLD in hospitalized patients with SCZ.

PATIENTS AND METHODS

This cross-sectional retrospective study included 310 patients who had experienced long-term hospitalization for SCZ. NAFLD was diagnosed based on the results of abdominal ultrasonography. The -test, Mann-Whitney -test, correlation analysis, and logistic regression analysis were used to determine the influence factors for NAFLD.

RESULTS

Among the 310 patients who had experienced long-term hospitalization for SCZ, the prevalence of NAFLD was 54.84%. Antipsychotic polypharmacy (APP), body mass index (BMI), hypertension, diabetes, total cholesterol (TC), apolipoprotein B (ApoB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), triglycerides (TG), uric acid, blood glucose, gamma-glutamyl transpeptidase (GGT), high-density lipoprotein, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio significantly differed between the NAFLD and non-NAFLD groups (all <0.05). Hypertension, diabetes, APP, BMI, TG, TC, AST, ApoB, ALT, and GGT were positively correlated with NAFLD (all <0.05). The results of the logistic regression analysis indicated that APP, diabetes, BMI, ALT, and ApoB were the influence factors for NAFLD in patients with SCZ.

CONCLUSION

Our results suggest a high prevalence of NAFLD among patients hospitalized long-term due to severe SCZ symptoms. Moreover, a history of diabetes, APP, overweight/obese status, and increased levels of ALT and ApoB were identified as negative factors for NAFLD in these patients. These findings may provide a theoretical basis for the prevention and treatment of NAFLD in patients with SCZ and contribute to the development of novel targeted treatments.

摘要

目的

长期住院的精神分裂症(SCZ)患者易患躯体疾病,导致预期寿命和治疗效果受损。关于非酒精性脂肪性肝病(NAFLD)对长期住院患者影响的研究较少。本研究旨在调查住院SCZ患者中NAFLD的患病率及其影响因素。

患者与方法

这项横断面回顾性研究纳入了310例因SCZ长期住院的患者。根据腹部超声检查结果诊断NAFLD。采用t检验、Mann-Whitney U检验、相关性分析和逻辑回归分析来确定NAFLD的影响因素。

结果

在310例因SCZ长期住院的患者中,NAFLD的患病率为54.84%。NAFLD组与非NAFLD组在抗精神病药物联合使用(APP)、体重指数(BMI)、高血压、糖尿病、总胆固醇(TC)、载脂蛋白B(ApoB)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、甘油三酯(TG)、尿酸、血糖、γ-谷氨酰转肽酶(GGT)、高密度脂蛋白、中性粒细胞与淋巴细胞比值以及血小板与淋巴细胞比值方面存在显著差异(均P<0.05)。高血压、糖尿病、APP、BMI、TG、TC、AST、ApoB、ALT和GGT与NAFLD呈正相关(均P<0.05)。逻辑回归分析结果表明,APP、糖尿病、BMI、ALT和ApoB是SCZ患者NAFLD的影响因素。

结论

我们的结果表明,因严重SCZ症状长期住院的患者中NAFLD患病率较高。此外,糖尿病史、APP、超重/肥胖状态以及ALT和ApoB水平升高被确定为这些患者NAFLD的危险因素。这些发现可能为SCZ患者NAFLD的预防和治疗提供理论依据,并有助于开发新的靶向治疗方法。

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