Increased Appetite Plays a Key Role in Olanzapine-Induced Weight Gain in First-Episode Schizophrenia Patients
Increased Appetite Plays a Key Role in Olanzapine-Induced Weight Gain in First-Episode Schizophrenia Patients
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食欲增加在奥氮平引起的首发精神分裂症患者体重增加中起着关键作用
DOI：
10.3389/fphar.2020.00739
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发表时间：
2020-05-22
影响因子：
5.6
通讯作者：
Wu, Ren-Rong
中科院分区：
文献类型：
--
作者：
Huang, Jing;Hei, Gang-Rui;Wu, Ren-Rong
可能受食欲增加影响的体重增加和代谢紊乱是奥氮平治疗精神分裂症患者的常见效应。在这项研究中，我们探讨了奥氮平诱导的体重增加与食欲增加的代谢作用之间的关系。药物初治的首发精神分裂症患者接受奥氮平治疗12周。评估包括至食欲增加的时间、体重、体重指数、血糖和血脂生化指标、治疗结束时体重增加超过基线体重7%或10%的患者比例、发生血脂异常的患者以及阳性和阴性症状量表评分。共入组了33例接受奥氮平治疗的精神分裂症患者，其中31例完成了研究。在12周奥氮平治疗期间，77.4%（24/31）的患者食欲增加，其中58.1%（18/31）的患者在前4周内食欲增加。食欲增加的平均时间为20.3天。与食欲不变的患者相比，食欲增加组中更多患者在12周后其初始体重增加超过7%（22/24 [91.7%] vs. 3/7 [42.9%]，p = 0.004）。早些时候食欲增加导致下个月体重增加更多。总体而言，食欲增加组中50%的患者在12周后出现血脂异常。我们的研究结果表明，奥氮平引起精神分裂症首发患者的食欲增加，食欲增加在奥氮平引起的体重增加和血脂异常中起关键作用。临床试验注册NCT 03451734。2018年3月2日注册（追溯注册）。
Weight gain and metabolic disturbances, potentially influenced by increased appetite, are common effects of olanzapine treatment in patients with schizophrenia. In this study, we explored the association between olanzapine-induced weight gain and metabolic effects with increased appetite. Drug-naïve, first-episode schizophrenia patients were treated with olanzapine for 12 weeks. Assessments included time to increased appetite, body weight, body mass index, biochemical indicators of blood glucose and lipids, proportion of patients who gained more than 7% or 10% of their baseline weight upon treatment conclusion, patients who developed dyslipidemia, and Positive and Negative Syndrome Scale scores. In total, 33 patients with schizophrenia receiving olanzapine were enrolled and 31 completed the study. During the 12-week olanzapine treatment, 77.4% (24/31) patients had increased appetite with 58.1% (18/31) patients having increased appetite within the first 4 weeks. The mean time for increased appetite was 20.3 days. More patients in the increased appetite group increased their initial body weight by more than 7% after 12 weeks when compared to patients with unchanged appetite (22/24 [91.7%] vs. 3/7 [42.9%], p = 0.004). Earlier increased appetite led to more weight gain during the following month. Overall, 50% of patients in the increased appetite group had dyslipidemia after 12 weeks. Our results demonstrated that olanzapine induced significantly appetite increase in first-episode patients with schizophrenia and appetite increase played a key role in olanzapine-induced weight gain and dyslipidemia. Clinical Trial Registration NCT03451734. Registered March 2, 2018 (retrospectively registered).