首发未用药精神分裂症患者糖代谢异常的情况及相关影响因素分析

目的:分析首发未用药精神分裂症患者伴发糖代谢异常的情况及相关影响因素。方法:选择80例首发未用药的精神分裂症患者作为病例组及同期进行体检的80例健康人作为对照组,根据口服OGTT试验将病例组分为糖代谢正常者和糖代谢异常者,收集病例组及对照组一般资料、及血糖相关指标进行分析。结果:病例组糖代谢异常发生率为38.75%,明显高于对照组(26.25%)(P0.05);病例组糖化血红蛋白、胰岛素抵抗指数(IR)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、皮质醇水平均明显高于对照(P0.05),而TSH水平明显低于对照组(P0.05);病例组中,糖代谢异常者皮质醇、FT3、FT4、IR、BMI、腰臀比明显高于糖代谢正常者(P0.05),TSH水平明显低于糖代谢正常者(P0.05);病例组中,糖代谢异常者餐后血糖7.8的比例随用药时间延长明显增高(P0.05)。结论:首发未经治疗的精神分裂症患者中糖代谢异常的构成比较健康人明显增高,属于2型糖尿病的高危人群。无抗精神病药物影响的前提下,肥胖、IR、皮质醇增高、FT4增高、TSH降低可能为精神分裂症患者发生糖代谢异常的危险因素。首发未经治疗的精神分裂症患者应用抗精神病药物治疗后餐后血糖会明显升高。

Analysis of the Glucose Metabolic Abnormalities in First-episode of Schizophrenia Patients without drug treatment and Related Factors

ABSTRACT Objective: Analysis of factors starting abnormalities in patients with schizophrenia and glucose metabolism associated with untreated strengthen abnormal glucose metabolism may occur for the early diagnosis of schizophrenia, prevention and treatment. Methods: Select the first history of untreated non-diabetic patients with schizophrenia as a group(n=80), the hospital medical center for medical examination of healthy people as a control group(n=80), according to oral OGTT test the case and control groups were divided into normal glucose metabolism, carbohydrate metabolism group, the case group and the control group were collected general information, and blood sugar related indicators, univariate and multivariate regression analysis. Results: Abnormal glucose metabolism in the case group was statistically significant higher than that in the control group(38.75% vs 26.25%, P<0.05). Cases of group glycated hemoglobin, insulin resistance index (IR), free triiodothyronine (FT3), free thyroxine (FT4), cortisol levels were significantly higher(P<0.05), and TSH levels were significantly lower than the control group (P<0.05). Cases of abnormal glucose metabolism groups in cortisol, waist circumference, waist-hip ratio, IR, BMI, FT4 glucose metabolism was significantly higher than the normal group(P<0.05), TSH levels were significantly lower than the control group(P<0.05). Abnormal glucose metabolism in the patient group was prolonged postprandial blood glucose with medication time > 7.8 significantly higher proportion(P<0.05). Conclusion: Episode untreated schizophrenic patients sugar metabolism constitute relatively healthy people increased significantly, belonging to high-risk populations with type 2 diabetes. Antipsychotic effect without, obesity, IR, elevated cortisol, FT4 increased, TSH reduce the risk factors that may occur as a disorder of glucose metabolism in patients with schizophrenia. After the application of antipsychotic treatment postprandial glucose significantly increased in first-episode of schizophrenia patients.