CAJ | 학술논문

目的探讨中国人群中精神分裂症患者可能的糖代谢异常及其原因.方法本研究设计为横断面研究,将222例研究对象分为4组:健康对照者44名(组1),首发未用药精神分裂症患者71例(组2),持续接受抗精神病药治疗≥1年精神分裂症患者68例(组3)、持续接受抗精神病药治疗≥1年且目前已经停药≥3个月的精神分裂症患者39例(组4).入组时采集所有研究对象的人口学资料和一般信息,测量身高、体质量、腰围、臀围,同时检测空腹血糖、胰岛素(INS)和C肽水平,并计算腰臀比(WHR)和胰岛素抵抗指数(IR).所有病例入组时均采用阳性和阴性症状量表进行评定,应用SPSS16.0统计软件对数据进行统计分析.结果 (1)组1与组2比较:组2的空腹INS、C肽和IR水平[(8.50±4.89) mU/L、(0.44 ±0.19) nmol/L、1.84±1.15]高于组1[(5.96 ±2.15) mU/L、(0.30±0.07) nmol/L、1.27 ±0.51](t=-3.83,-5.29,-3.56,P均＜0.01),组2的WHR(0.82±0.06)＞组1(0.79±0.06)(t=-1.92,P=0.05).(2)组2与组3比较:组3的BMI、腰围、WHR、空腹INS和IR水平[(23.20±3.72) kg/m2、(81.60±10.32) cm、0.88±0.06、(12.14±6.63) mU/L、2.64±1.43]均高于组2[(19.62 ±2.51) kg/m2、(70.42 ±7.57) cm、0.82±0.06、(8.50 ±4.89) mU/L、1.84±1.15](t=6.58,7.21,5.39,3.66,3.61,P均＜0.01),空腹C肽水平(0.53 ±0.22) nmol/L高于组2(0.44 ±0.19) nmol/L(t =2.50,P＜0.05).(3)组3与组4比较:组4的腰围、WHR[(79.01±10.93)cm、0.86±0.08]＜组3[(81.60±10.32) cm、0.88±0.06](=4.30,4.79,P均＜0.05).结论中国精神分裂症患者可能已潜在胰岛素合成及利用障碍,抗精神病药可能加剧糖代谢紊乱；平均(0.92±0.82)年的停药可能利于腰围和腰臀比的改善,但尚难逆转糖代谢紊乱.
목적 탐토중국인군중정신분렬증환자가능적당대사이상급기원인.방법 본연구설계위횡단면연구,장222례연구대상분위4조:건강대조자44명(조1),수발미용약정신분렬증환자71례(조2),지속접수항정신병약치료≥1년정신분렬증환자68례(조3)、지속접수항정신병약치료≥1년차목전이경정약≥3개월적정신분렬증환자39례(조4).입조시채집소유연구대상적인구학자료화일반신식,측량신고、체질량、요위、둔위,동시검측공복혈당、이도소(INS)화C태수평,병계산요둔비(WHR)화이도소저항지수(IR).소유병례입조시균채용양성화음성증상량표진행평정,응용SPSS16.0통계연건대수거진행통계분석.결과 (1)조1여조2비교:조2적공복INS、C태화IR수평[(8.50±4.89) mU/L、(0.44 ±0.19) nmol/L、1.84±1.15]고우조1[(5.96 ±2.15) mU/L、(0.30±0.07) nmol/L、1.27 ±0.51](t=-3.83,-5.29,-3.56,P균＜0.01),조2적WHR(0.82±0.06)＞조1(0.79±0.06)(t=-1.92,P=0.05).(2)조2여조3비교:조3적BMI、요위、WHR、공복INS화IR수평[(23.20±3.72) kg/m2、(81.60±10.32) cm、0.88±0.06、(12.14±6.63) mU/L、2.64±1.43]균고우조2[(19.62 ±2.51) kg/m2、(70.42 ±7.57) cm、0.82±0.06、(8.50 ±4.89) mU/L、1.84±1.15](t=6.58,7.21,5.39,3.66,3.61,P균＜0.01),공복C태수평(0.53 ±0.22) nmol/L고우조2(0.44 ±0.19) nmol/L(t =2.50,P＜0.05).(3)조3여조4비교:조4적요위、WHR[(79.01±10.93)cm、0.86±0.08]＜조3[(81.60±10.32) cm、0.88±0.06](=4.30,4.79,P균＜0.05).결론 중국정신분렬증환자가능이잠재이도소합성급이용장애,항정신병약가능가극당대사문란；평균(0.92±0.82)년적정약가능리우요위화요둔비적개선,단상난역전당대사문란.
Objective To explore the potential glycometabolism abnormality and the related factors of schizophrenia patients in China.Methods This cross-sectional study included 44 healthy controls (group 1) and 178 inpatient schizophrenia patients,including 71 drug-naive first-episode patients (group 2),68 patients with continuous antipsychotics medication of ≥ 1 year (group 3) and 39 patients with continuous antipsychotics medication of ≥ 1 year and drug withdrawal of ≥ 3 months (group 4).At baseline,the demographic characteristics were collected.The weight,height,waistline,hipline,fasting blood glucose,fasting insuline and fasting C-peptide level were measured.The Positive and Negative Syndrome Scale (PANSS) were assessed in patients.Results (1) Group 2 showed a higher level of INS,C-peptide,IR [(8.50 ± 4.89) mU/L,(0.44 ± 0.19) nmol/L,1.84 ± 1.15] than group 1 [(5.96 ± 2.15) mU/L,(0.30 ±0.07) nmol/L,1.27 ± 0.51] (t =-3.83,-5.29,-3.56 ; P ＜ 0.01),and its WHR (0.82 ± 0.06) was larger than group 1 (0.79 ± 0.06 ;t =-1.92,P =0.05).(2) Group 3 showed a much higher level of BMI,waistline,WHR,INS and IR[(23.20 ± 3.72) kg/m2,(81.60 ± 10.32) cm,0.88 ± 0.06,(12.14 ± 6.63)mU/L,2.64 ± 1.43] than group 2 [(19.62 ±2.51) kg/m2,(70.42±7.57) cm,0.82±0.06,(8.50±4.89) mU/L,1.84 ± 1.15] (t = 6.58,7.21,5.39,3.66,Ps ＜ 0.01),and its fasting C-peptide level (0.53 ±0.22) nmol/L was higher than group 2 (0.44 ± 0.19) nmol/L (t =2.50,P ＜ 0.05).(3) Group 4 showed lower waistline and WHR [(79.01 ± 10.93) cm,0.86 ± 0.08] than group 3 [(81.60 ± 10.32) cm,0.88 ±0.06] (t =4.30,4.79;Ps ＜0.05),however,the glyeometabolism parameters between groups had no difference (P ＞ 0.05).Conclusions These findings suggest that the schizophrenia patients maybe have some impairment of synthesis and utilization of insulin,and antipsychotics treatment could exacerbate glycometabolic disturbances.