Metformin treatment of antipsychotic-induced dyslipidemia: an analysis of two randomized, placebo-controlled trials.
Metformin treatment of antipsychotic-induced dyslipidemia: an analysis of two randomized, placebo-controlled trials.
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二甲双胍治疗抗精神病药物引起的血脂异常：两项随机、安慰剂对照试验的分析
DOI：
10.1038/mp.2015.221
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发表时间：
2016-11
影响因子：
11
通讯作者：
Zhao, J-P
中科院分区：
文献类型：
--
作者：
Wu, R-R;Zhang, F-Y;Gao, K-M;Ou, J-J;Shao, P.;Jin, H.;Guo, W-B;Chan, P. K.;Zhao, J-P
血脂异常是精神分裂症患者抗精神病药物治疗中最常见的不良反应之一。然而，目前还没有有效的治疗方法。在这项研究中，数据来自两项随机、安慰剂对照试验，这些试验最初旨在检查二甲双胍治疗抗精神病药诱导的体重增加和其他代谢异常的疗效。总共有201例接受抗精神病药物治疗后出现血脂异常的精神分裂症患者被分配接受1000 mg第1天二甲双胍（n= 103）或安慰剂（n= 98）治疗24周，并在基线、第12周和第24周进行评估。主要结果是低密度脂蛋白胆固醇（LDL-C）水平。二甲双胍治疗后，二甲双胍治疗组和安慰剂组之间LDL-C值的平均差异从基线时的0.16 mmol l-1降至第24周结束时的-0.86 mmol l-1，降低了1.02 mmol l-1二甲双胍组中25.3%的患者具有LDL-C≥ 3.37 mmol l-1，在第24周时，这在安慰剂组中显著< 64.8%（P< 0.001）。与安慰剂相比，二甲双胍治疗对降低体重、体重指数、胰岛素、胰岛素抵抗指数、总胆固醇和甘油三酯、升高高密度脂蛋白胆固醇也有显著作用。对体重和胰岛素抵抗的治疗效果在第12周出现，并在第24周进一步改善，但对血脂异常的改善效果仅在第24周末显著出现。我们发现二甲双胍治疗可有效改善抗精神病药所致的血脂异常和胰岛素抵抗，且改善抗精神病药所致的胰岛素抵抗的作用早于降低血脂异常。
Dyslipidemia is one of the most common adverse effects in schizophrenia patients treated with antipsychotics. However, there are no established effective treatments. In this study, data were pooled from two randomized, placebo-controlled trials, which were originally designed to examine the efficacy of metformin in treating antipsychotic-induced weight gain and other metabolic abnormalities. In total, 201 schizophrenia patients with dyslipidemia after being treated with an antipsychotic were assigned to take 1000 mg day–1 metformin (n= 103) or placebo (n= 98) for 24 weeks, with evaluation at baseline, week 12 and week 24. The primary outcome was the low-density lipoprotein cholesterol (LDL-C) levels. After metformin treatment, the mean difference in the LDL-C value between metformin treatment and placebo was from 0.16 mmol l–1 at baseline to–0.86 mmol l–1 at the end of week 24, decreased by 1.02 mmol l–1 (P< 0.0001); and 25.3% of patients in the metformin group had LDL-C≥ 3.37 mmol l–1, which is significantly< 64.8% in the placebo group (P< 0.001) at week 24. Compared with the placebo, metformin treatment also have a significant effect on reducing weight, body mass index, insulin, insulin resistance index, total cholesterol and triglyceride, and increasing high-density lipoprotein cholesterol. The treatment effects on weight and insulin resistance appeared at week 12 and further improved at week 24, but the effects on improving dyslipidemia only significantly occurred at the end of week 24. We found that metformin treatment was effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effects improving antipsychotic-induced insulin resistance appeared earlier than the reducing dyslipidemia.
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影响因子：
5.3
作者：
Henderson, David C.;Doraiswamy, P. Murali
通讯作者：
Doraiswamy, P. Murali
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158.5
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