The prevention of diabetes and cardiovascular disease in people with schizophrenia
The prevention of diabetes and cardiovascular disease in people with schizophrenia
复制标题
DOI：
10.1111/acps.12443
复制
发表时间：
2015-08-01
影响因子：
6.7
通讯作者：
Holt, R. I. G.
中科院分区：
文献类型：
--
作者：
Holt, R. I. G.
目的对精神分裂症患者进行糖尿病和心血管疾病的一级预防。本综述旨在确定生活方式和药物干预可以减少精神分裂症患者的糖尿病和心血管疾病。方法检索pubmed等电子数据库，检索相关文献。结果注重饮食和身体活动的生活方式干预可降低糖尿病的发病率。精神分裂症患者的类似项目已经导致了显著的体重减轻，并且可以合理地期望长期减少糖尿病。当生活方式改变不可行或不有效时，可以考虑使用二甲双胍。生活方式干预，特别是戒烟，可能对减少精神分裂症患者的心血管疾病有效。虽然他汀类药物的心血管预防试验尚未在精神分裂症患者中进行，但胆固醇的降低与一般人群相似，他汀类药物应考虑用于高危人群。传统的心血管风险预测模型在识别心血管高风险人群方面表现良好，但使用精神分裂症患者数据的定制预测模型表现更好。结论：减少糖尿病和心血管疾病需要精神和身体健康团队在初级和二级保健中协调一致的努力。
ObjectivePrimary prevention of diabetes and cardiovascular disease is an important priority for people with schizophrenia. This review aims to identify lifestyle and pharmacological interventions that reduce diabetes and cardiovascular disease in people with schizophrenia.MethodPubMed and other electronic databases were searched to identify relevant articles.ResultsLifestyle interventions that focus on diet and physical activity reduce the incidence of diabetes. Similar programmes in people with schizophrenia have led to significant weight loss and may reasonably be expected to reduce diabetes in the long-term. Metformin may be considered when lifestyle change is not feasible or effective. Lifestyle interventions, particularly smoking cessation, are likely to be effective in reducing cardiovascular disease in people with schizophrenia. Although cardiovascular prevention trials with statins have not been performed in people with schizophrenia, similar reductions in cholesterol has been seen as in the general population and statins should be considered for those at high risk. Traditional cardiovascular risk prediction models perform well in identifying those at high cardiovascular risk, but bespoke prediction models using data from people with schizophrenia perform better.ConclusionReducing diabetes and cardiovascular disease requires a coordinated and concerted effort from mental and physical health teams working across primary and secondary care.