服用Clozapine之精神分裂症病患罹患代謝症候群之盛行率

Prevalence of Metabolic Syndrome in Patients with Schizophrenia Taking Clozapine

楊欣茹(Hsin-Ju Yang) ； 邵文娟(Wen-Chuan Shao) ； 吳培君(Pei-Chun Wu) ； 林靜蘭(Esther Ching-Lan Lin) ； 林梅鳳(Mei-Feng Lin)

《護理暨健康照護研究》 8卷4期 (2012/12) Pp. 316-324

https://doi.org/10.6225/JNHR.08.4.316

摘要

Background: The prevalence of metabolic syndrome in the general population is estimated to be about 20-25%. A higher prevalence has been reported in patients with schizophrenia taking atypical antipsychotics, particularly clozapine and olanzapine.Purpose: This study examined the prevalence of metabolic syndrome and related factors in institutionalized patients with schizophrenia taking clozapine.Methods: Between March and September 2010, we collected data on metabolic syndrome parameters from the medical charts of schizophrenia patients who had taken clozapine for at least for 3 months. All participants were residents of chronic psychiatric patient wards. We estimated the prevalence of metabolic syndrome in accordance with International Diabetes Federation guidelines and examined associations between demographic and illness factors.Results: The prevalence of metabolic syndrome in the 146 patients reviewed was 26.71%. Waist diameter and highdensity lipoprotein-cholesterol levels were the most important markers of metabolic syndrome. We found significant differences between the prevalence of metabolic syndrome and abnormal BMI (p = .028) and polypharmacy (p ＜ .001). Logistic multiple regression analysis indicated sex, age, polypharmacy, and abnormal BMI to be significant predictors of metabolic syndrome (p ＜ .001).Conclusions / Implications for Practice: The prevalence of metabolic syndrome in this study was slightly higher than in the general population, which is consistent with prior studies on Western populations. We hope our findings will inform healthcare providers about safety issues and other factors related to antipsychotic medications and increase nurse awareness about the physical health problems of this population. Ecological validity was limited because our patients were institutionalized and the study was cross-sectional. Additional investigations are required.

關鍵字

精神分裂症病患 ； clozapine ； 代謝症候群 ； 盛行率

並列摘要

Background: The prevalence of metabolic syndrome in the general population is estimated to be about 20-25%. A higher prevalence has been reported in patients with schizophrenia taking atypical antipsychotics, particularly clozapine and olanzapine.Purpose: This study examined the prevalence of metabolic syndrome and related factors in institutionalized patients with schizophrenia taking clozapine.Methods: Between March and September 2010, we collected data on metabolic syndrome parameters from the medical charts of schizophrenia patients who had taken clozapine for at least for 3 months. All participants were residents of chronic psychiatric patient wards. We estimated the prevalence of metabolic syndrome in accordance with International Diabetes Federation guidelines and examined associations between demographic and illness factors.Results: The prevalence of metabolic syndrome in the 146 patients reviewed was 26.71%. Waist diameter and highdensity lipoprotein-cholesterol levels were the most important markers of metabolic syndrome. We found significant differences between the prevalence of metabolic syndrome and abnormal BMI (p = .028) and polypharmacy (p ＜ .001). Logistic multiple regression analysis indicated sex, age, polypharmacy, and abnormal BMI to be significant predictors of metabolic syndrome (p ＜ .001).Conclusions / Implications for Practice: The prevalence of metabolic syndrome in this study was slightly higher than in the general population, which is consistent with prior studies on Western populations. We hope our findings will inform healthcare providers about safety issues and other factors related to antipsychotic medications and increase nurse awareness about the physical health problems of this population. Ecological validity was limited because our patients were institutionalized and the study was cross-sectional. Additional investigations are required.

並列關鍵字

schizophrenia ； clozapine ； metabolic syndrome ； prevalence