血清瘦素与抗精神病药源性肥胖及糖尿病的相关性研究

目的　调查和探讨长期使用抗精神病药患者血瘦素水平及其与服用抗精神病药后体重 增加、肥胖及糖尿病之间的关系。方法　对符合入组标准的308例长期服用抗精神病药的精神分裂症 患者分为对照组、肥胖组、糖耐量减低组及糖尿病组,比较血清瘦素水平、胰岛素抵抗指数、血清甘油三 酯及总胆固醇水平。结果　(1)肥胖组、糖耐量减低组及糖尿病组患者的血清瘦素水平、胰岛素抵抗指 数、血清甘油三酯及总胆固醇水平均显著高于对照组(P<0.05)。(2)长期应用抗精神病药患者血瘦 素水平与体重指数、简易胰岛素抵抗指数、空腹血糖、血甘油三酯及胆固醇均呈极显著正相关(P<0.01 ～0.0001),而与餐后2h血糖水平及用药时间无相关性。结论　长期应用抗精神病药患者血瘦素水 平在肥胖、糖耐量降低及糖尿病患者中显著升高,且与体重指数、简易胰岛素抵抗指数、空腹血糖水平等 均呈显著正相关,提示高血清瘦素水平是长期应用抗精神病药所致的代谢紊乱综合征的重要指征之一。

A study of relationship between serum leptin and obesity,diabetes mellitus related to antipsychotics

Objective: To investigate and explore the relationship among serum leptin and obesity, diabetes mellitus related to antipsychotics in inpatients with schizophrenia. Methods: 308 inpatients met with schizophrenia were divided into four groups: controls, obesity , impaired glucose tolerance (IGT) and diabetes mellitus according to BMI, fasting blood glucose and 2-hour blood glucose after breakfast. Results: (1) Serum leptin levels, HOMA-insulin resistance (HOMA-IR), serum triglycerides and cholesterol in obesity, IGT and DM group were significantly higher than that in controls. (2) Serum leptin levels in schizophrenic patients with long term using antipsychotics had remarkable positive correlation with body mass index, HOMA-IR, fasting blood glucose, serum triglycerides and cholesterol level, but had no significant correlation with 2-hour blood glucose after breakfast and the period of using antipsychotics. Conclusion: Serum leptin levels experience significant increase in patients with obesity, IGT and DM related to long term using antipsychotics, and had remarkable positive correlation with BMI, HOMA-IR. This suggests that serum leptin levels would be an important trait of metabolic syndrome related to long term using antipsychotics.