首发精神病患者催乳素水平与临床结局的性别差异。
Sex differences in prolactin levels and clinical outcomes in patients with a first psychotic episode.
机构信息
Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Catalonia, Spain.
Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain; Serra-Hunter Fellow, Department of Basic Clinal Practice, Pharmacology Unit, University of Barcelona.
出版信息
Psychoneuroendocrinology. 2024 Nov;169:107112. doi: 10.1016/j.psyneuen.2024.107112. Epub 2024 Aug 5.
AIM
To analyze the clinical, neurocognitive, and functional impact of prolactin levels according to sex in patients with a First Episode Psychosis (FEP).
METHODS
We measured prolactin levels in 221 non-affective FEP patients treated with antipsychotics (AP) and 224 healthy controls, at baseline and 2-year follow-up. We examined whether the relationships between clinical and functional variables were mediated by prolactin, controlling for antipsychotic use, according to sex.
RESULTS
Prolactin levels were higher in patients when compared to controls at both time points. Baseline factors associated with prolactin were chlorpromazine equivalents, attention, and executive functioning. In the FEP group, prolactin levels were associated with functioning and diminished expression in males, and with working memory in females. Prolactin levels (p=0.0134) played a role as a mediator between negative symptomatology (p=0.086) and functional outcome (p=0.008) only in FEP male patients at baseline.
CONCLUSIONS
Prolactin plays a role in the functionality and clinical symptomatology of FEP patients. Our results suggest that pharmacological counselling in patients with hyperprolactinemia at baseline and negative symptomatology might improve their functional and clinical outcomes.
目的
分析首发精神病（FEP）患者中根据性别不同的催乳素水平对临床、神经认知和功能的影响。
方法
我们在基线和 2 年随访时测量了 221 名接受抗精神病药物（AP）治疗的非情感性 FEP 患者和 224 名健康对照者的催乳素水平。我们根据性别，检查了催乳素是否可以调节临床和功能变量之间的关系，同时控制抗精神病药物的使用。
结果
与对照组相比，患者在两个时间点的催乳素水平均较高。与催乳素相关的基线因素是氯丙嗪等效物、注意力和执行功能。在 FEP 组中，催乳素水平与男性的功能和表达能力下降以及女性的工作记忆有关。催乳素水平（p=0.0134）在 FEP 男性患者中仅在基线时在阴性症状（p=0.086）和功能结果（p=0.008）之间发挥了中介作用。
结论
催乳素在 FEP 患者的功能和临床症状中起作用。我们的研究结果表明，在基线时存在高催乳素血症和阴性症状的患者中进行药物咨询可能会改善他们的功能和临床结果。
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