长期服药精神分裂症患者血浆瘦素胰岛素及胰岛素抵抗的相关性研究  

The study of relationship between fasting plasma leptin, fasting plasma insulin and HOMA insulin resistance index in patients with schizophrenia treated chronically by antipsychotic agents

作　　者：孙静[1] 张志珺[1] 王从杰[1] 张晓斌[1] 王筱兰[1] 尚晓芳[1] 朱荣鑫[1] 束飞[1] 

机构地区：[1]南京医科大学附属脑科医院精神一科,南京210029

出　　处：《中国行为医学科学》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)

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.

关 键 词：精神分裂症 空腹瘦素 空腹胰岛素 胰岛素抵抗 HOMA胰岛素抵抗指数 精神分裂症患者 血浆瘦素 瘦素(leptin) 长期服药 胰岛素水平 抗精神病药物 HOMA-IR 空腹血糖 

分 类 号：R749.3[医药卫生—神经病学与精神病学]