Effect of Second Generation Antipsychotics on the Metabolic Syndrome Parameters in Patients with Schizophrenia

第二代抗精神病藥物對精神分裂症病患代謝症候群影響研究

黃尚堅(Shang-Chien Huang) ； 黃湘萍(Hsiang-Ping Huang) ； 李麗敏(Li-Min Lee) ； 張麗雅(Li-Ya Chang) ； 洪明姿(Ming-Tzu Hung)

《童綜合醫學雜誌》 4卷2期 (2010/12) Pp. 63-69

https://doi.org/10.29838/TMJ.201012.0002

摘要

目的：代謝症候群是第二代抗精神病藥物在治療使用上的一個關注焦點，它已被建立為第二型糖尿病及心血管疾病之危險因子，且增加冠狀動脈心臟病及中風三倍的危險性。本研究希望能進一步了解第二代抗精神病藥物對國人代謝症候群之影響。
方法：41位無個人及家族糖尿病史之精神分裂症患者，使用第二代抗精神病藥物治療，在使用前及使用一年後給予生化、血壓、腰圍檢查，並依NCEP(National Cholesterol Education Program)標準判定是否有代謝症候群。統計方法為平均數差異檢定及變異數分析。
結果：41位個案用藥前有代謝症候群者6位(14.6%)，用藥後有代謝症候群者11位(26.8%)。用藥後無新增糖尿病患者。全數病患在使用第二代抗精神病藥物前後三酸甘油酯平均增加37mg/dl呈現顯著差異，以個別藥物而言，用藥前後三酸甘油酯呈現顯著差異的是Clozapine及Olanzapine。全數病患在使用第二代抗精神病藥物前後體重平均增加5.3kg呈現顯著差異，以個別藥物而言，用藥前後體重呈現顯著差異為Olanzapine。其它各項檢查未呈現顯著差異。
結論：研究結果顯示在第二代抗精神病藥物用藥後，部份藥物對體重及三酸甘油酯有顯著影響。用藥後出現代謝症候群者，比一般國人及美國成年人盛行率為高。

並列摘要

Purpose: Metabolic syndrome is a focus of attention in the application of second generation antipsychotics, which has been regarded as a risk factor of Type 2 Diabetes and cardiovascular diseases and may raise the incidence of coronary heart disease and stroke by a factor of three. This study aims to explore the effect of second generation antipsychotics on the occurrence of the metabolic syndrome of Taiwanese patients.
Method: A total of 41 schizophrenic patients without personal and family history of diabetes were recruited and they were treated with the second generation antipsychotics. An examination including biochemical status, blood, waistline and body weight was given to them and a judgment of metabolic syndrome was executed according to the diagnosis principles of NCEP ATP III modified criteria for Asians before and one year after the treatment. The statistic method applied including means comparison and analysis of variance.
Result: There were 6 metabolic syndrome patients found (14.6%) before treatment and the prevalence increased to 26.8% (11 of 41 patients) after one-year of treatment. No new diabetes patients were observed after taking the antipsychotics. Triglyceride values increased by an average of 37 mg/dl and presented a significant variance for all of the patients after taking the second generation antipsychotics. With regards to the individual drug, Clozapine and Olanzapine caused a significant variance in triglyceride values. Body weight of all patients increased in an average of 5.3 kg and exhibited a significant variance after taking the antipsychotics. With respect to individual drug, patients displayed a remarkable variance in body weight after taking Olanzapine. No significant variances exhibited for other items of drugs being examined.
Conclusion: This study demonstrated that part of second generation antipsychotics could exert remarkable influences on body weight and triglyceride value. And patients after taking the antipsychotics presented a higher prevalence rate of metabolic syndrome than general Taiwanese and American adults.

並列關鍵字

Metabolic ； Antipsychotics ； Schizophrenia