低能量膳食对奥氮平所致体质量增加的男性精神分裂症患者糖脂代谢的影响

目的:探讨低能量膳食对奥氮平所致体质量增加的男性精神分裂症患者糖脂代谢的影响。方法:选择2018年4月至2019年4月124例奥氮平所致体重增加的精神分裂症患者为研究对象,按照随机数字法分为A组(奥氮平片20 mg/d)、B组(奥氮平片20 mg/d联合二甲双胍片750 mg/d)和C组(奥氮平片20 mg/d联合低能量膳食)。比较3组患者治疗前和治疗3个月后体质量指数和糖脂代谢的变化。结果:治疗3个月后,A组体质量指数、空腹血糖、餐后2 h血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇均高于B组和C组,高密度脂蛋白胆固醇低于B组和C组(P均<0.05)。B组低密度脂蛋白胆固醇高于C组(P<0.05),B组和C组在体质量指数、空腹血糖和餐后2 h血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇方面差异无统计学意义(P均>0.05)。结论:低能量膳食控制奥氮平所致体重增加的男性精神分裂症患者糖脂代谢水平的疗效与二甲双胍相当,提示膳食干预可作为该群体糖脂代谢异常的非药物性干预方案。

Effect of low energy diet on metabolism of glucose and lipid in male schizophrenic patients with olanzapine-induced increase in body mass

Objective:To investigate the effect of the low energy diet on glucose and lipid metabolism in schizophrenic patients with weight gain induced by olanzapine.Method:124 patients with schizophrenia who had gained weight due to olanzapine treatment from April 2018 to April 2019 were selected as the study objects.According to the random number method,they were divided into group A(olanzapine 20 mg/d),group B(olanzapine 20 mg/d and metformin 750 mg/d)and group C(olanzapine 20 mg/d and low-energy diet).Changes of body mass index and glycolipid metabolism in the 3 groups were compared at baseline and after 3 months of treatment.Results:After 3 months of treatment,the body mass index,the fasting blood glucose,2 hour postprandial blood glucose,total cholesterol,triacylglycerol,low density lipoprotein cholesterol in the group A were higher than those in the group B and group C,while high density lipoprotein cholesterol was higher than that in the group B and group C(all P<0.05).Low density lipoprotein cholesterol of the group B was higher than that of the group C(P<0.05).There were no statistical significant differences in the body mass index,fasting blood glucose and 2 hour postprandial blood glucose,total cholesterol,triacylglycerol,high-density lipoprotein cholesterol among the group B and group C(all P>0.05).Conclusion:The efficacy of low-energy diet on glucose and lipid metabolism in male schizophrenic patients with weight gain induced by olanzapine is equivalent to metformin,suggesting that dietary intervention can be used as a non-drug intervention program for this group with abnormal glucose and lipid metabolism.