Equally increased risk for metabolic syndrome in patients with bipolar disorder and schizophrenia treated with second-generation antipsychotics
Equally increased risk for metabolic syndrome in patients with bipolar disorder and schizophrenia treated with second-generation antipsychotics
复制标题
DOI：
10.1111/j.1399-5618.2008.00625.x
复制
发表时间：
2008-11-01
影响因子：
5.4
通讯作者：
Manu, Peter
中科院分区：
文献类型：
--
作者：
Correll, Christoph U.;Frederickson, Anne M.;Manu, Peter
目的：尽管第二代抗精神病药（SGA）广泛用于治疗精神分裂症和双相情感障碍，但它们对血脂异常，葡萄糖不耐症，代谢综合征（METS）和冠心病（CHD）的影响对双极疾病的风险较小。我们比较了接受SGA的双相情感障碍和精神分裂症患者，以确定METS的患病率是否受到原发性精神诊断或同伴情绪稳定剂的影响。方法：Mets标准的录取评估（腹部肥胖症，斋戒，快甘油后血症，高密度Lipoporotein contypopotin Colysterlia，高密度lipoporotein collesterolia，高密度lipolotelycemia，高密度lipopoparotia，gypycemia，高密度lipolotely，gypypysin，gypoprotia，高密度，gypycemia，高密度，gypycemia，高含量。动脉高血压）和计算10年双相情感障碍和精神分裂症患者的CHD风险接受SGA治疗并与年龄，性别和种族密切相匹配。分析：与精神分裂症患者（n = 111）相比，双相情感障碍（n = 74）患有较低体内的患者（27.11 +/- 5.3对29.9 +/- 8.1，p = 0.0053），更有可能用情绪稳定器处理（60.8对与36.0，p = 0.0009），用氯氮平治疗的可能性较小（1.3％对15.3％，p = 0.0017）或两种抗精神病药（10.8％对34.2％，p = 0.0003）。尽管存在这些差异，但双相情感障碍和精神分裂症患者的Met率（43.2％对45.9％，P = 0.71）和预测的CHD事件（10年风险> 10％：18.9％对23.4％，P = 0.47）。在两个诊断组中，使用100 mg/dl作为适应的葡萄糖标准，MetS率为54.0％（p = 1.0）。情绪稳定剂共同治疗与Mets或其各个标准无关。结论：接受SGA治疗的双相情感障碍和精神分裂症患者的MetS率同样很高。这些。研究结果表明，对抗精神病药相关的代谢失调具有共同的敏感性，这与精神诊断或随之而来的情绪稳定剂治疗无关。
Objective: Although second-generation antipsychotics (SGAs) are widely used in treating schizophrenia and bipolar disorder, their effects on dyslipidemia, glucose intolerance, metabolic syndrome (MetS), and coronary heart disease (CHD) risk are less well documented for bipolar disorder. We compared bipolar disorder and schizophrenia patients receiving SGAs to determine whether MetS prevalence is influenced by the primary psychiatric diagnosis or concomitant mood stabilizer treatment.Methods: Admission assessment of MetS criteria (abdominal obesity, fasting hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, arterial hypertension) and the calculated 10-year CHD risk in bipolar disorder and schizophrenia patients treated with SGAs and closely matched for age, sex, and race.Results: Compared to schizophrenia patients (n = 111), those with bipolar disorder (n = 74) had lower body mass index (27.1 +/- 5.3 versus 29.9 +/- 8.1, p = 0.0053), were more likely treated with mood stabilizers (60.8 versus 36.0, p = 0.0009), and less likely treated with clozapine (1.3% versus 15.3%, p = 0.0017) or two antipsychotics (10.8% versus 34.2%, p = 0.0003). Despite these differences, bipolar disorder and schizophrenia patients had comparable rates of MetS (43.2% versus 45.9%, p = 0.71) and predicted CHD events (10-year risk > 10%: 18.9% versus 23.4%, p = 0.47). Using 100 mg/dL as the adapted glucose criterion, MetS rates were 54.0% in both diagnostic groups (p = 1.0). Mood stabilizer co-treatment was not associated with MetS or its individual criteria.Conclusions: Patients with bipolar disorder and schizophrenia who are treated with SGAs have similarly high rates of MetS. These. findings suggest a shared susceptibility to antipsychotic-related metabolic dysregulations that is not primarily related to psychiatric diagnosis or concomitant mood stabilizer treatment.