摘要
目的研究长期服用抗精神病药物的慢性精神分裂症患者空腹血清瘦素、胰岛素水平和胰岛素抵抗及其之间的关系。方法218例病程>5年的慢性精神分裂症患者接受糖尿病流行病学调查,测定空腹血糖、餐后2h血糖、空腹瘦素(leptin)和空腹胰岛素(FINS)水平。根据血糖水平及糖尿病临床症状,分为糖尿病组(DM组)、血糖调节异常组(AGT组,包括IFG和IGT)和血糖正常组(NGT组,其中BMI<26归为NGTa组;BMI≥26归为NGTb组)。结果DM组空腹瘦素[(30.05±10.76)ng/ml]、胰岛素[(13.35±4.99)μIu/ml]水平高于NGTa组[分别为(24.35±10.74)ng/ml、(10.86±3.30)μIu/ml;P<0.05和P<0.01];整体患者leptin与FINS呈显著正相关(r=0.210,P=0.005),进一步分组做相关分析,NGTa组、NGTb组leptin与FINS均呈显著正相关(r=0.277,P=0.014;r=0.457,P=0.017)。整体患者leptin与HOMA胰岛素抵抗指数(HOMA-IR)呈显著正相关(r=0.231,P=0.002),分组后NGTa组leptin与HOMA-IR呈正相关(r=0.228,P=0.045)。结论长期服用抗精神病药物(APS)可引起血leptin、FINS水平升高,当两者处于失平衡状态时,就会导致血糖调节异常及糖尿病,推测APS引起的瘦素水平增高可能参与了胰岛素抵抗,而导致糖尿病的发生。
Objective To investigate the association between fasting plasma leptin, fasting plasma insulin and HOMA insulin resistance index （HOMA-IR） in patients with schizophrenia treated chronically antipsychotic agents. Methods Fasting plasma glucose, 2-hour post meal plasma glucose,fasting plasma leptin and fasting plasma insulin were measured in 218 chronic patients with schizophrenia whose natural courses of the disorder were more than 5 years. According to the level of plasma glucose, these patients were divided into three groups, diabetes mellitus group, abnormal regulating glucose group and normal glucose group. Results As compared to normal glucose group （NGTa） , patients in diabetes mellitus group had a higher plasma level of fasting leptin and fasting insulin （ P〈 0.05 and P 〈 0.01 ）. The level of fasting plasma leptin was significantly correlated with the level of fasting plasma insulin in NGTa group and NGTb group （ r = 0. 277, P = 0. 014 ; r = 0. 457, P = 0. 017）. There was a significant correlation between the level of fasting plasma leptin and HOMA-IR index in NGTa group （ r = 0. 228, P= 0. 045）. Conclusion There is dysregulation between fasting plasma leptin and fasting insulin, as well as HOMA-IR index,in some of those patients who had taken antipsychotics for a long period of time.
出处
《中国行为医学科学》
CSCD
2005年第10期905-907,共3页
Chinese Journal of Behavioral Medical Science
基金
国家自然科学基金资助项目(30170344)
