长期使用抗精神病药患者血清游离脂肪酸水平与有关因素研究

目的:探讨长期(1年以上)使用抗精神病药患者的血清游离脂肪酸(FFAs)水平,及其与空腹血糖和胰岛素抵抗之间的关系. 方法:调查308例长期使用抗精神病药住院患者,用比色法检测患者空腹血清FFAs,用放射免疫法测定患者血清胰岛素和瘦素. 结果:与长期使用抗精神病药有关的体质量(体重)增加或肥胖、糖耐量降低和糖尿病患者的血清FFAs水平显著高于对照组(P值分别为0.04, 0.01和0.022),且与空腹血糖、胰岛素抵抗均呈显著正相关(P值分别为0.005和0.04). 结论:长期使用抗精神病药的精神分裂症患者的高血清FFAs水平影响患者的糖代谢,并参与胰岛素抵抗乃至糖尿病的发生,是代谢紊乱综合征的重要特征之一.

Study of serum free fatty acids level in patients treated by antipsychotics for long-term and its related factors

Objective:To investigate the level of serum free fatty acids(FFAs) in schizophrenic patients treated by antipsychotics for a long period of time(more than 1 year),and explore the associations between serum FFAs and fasting blood glucose and insulin resistance. Method:308 schizophrenic inpatients were recruited into this study.Serum FFAs level was measured with colorimetry.Serum insulin and leptin were measured with radioimmunoassay. Results:The serum FFAs level in schizophrenic patients treated by antipsychotics for long-term was elevated significantly,especially in weight gain or obesity,impaired glucose tolerance and diabetes mellitus(P value:0.04,0.01 and 0.022 respectively),and it had remarkable positive correlation with fasting blood glucose and insulin resistance(P value:0.005 and 0.04 respectively). Conclusion:The elevated FFAs level in schizophrenic patients treated by antipsychotics for long-term would affect blood glucose metabolism,even play an important role in insulin resistance and diabetes mellitus,and was also one of important traits of metabolic syndrome.