二甲双胍对奥氮平致体重增加的精神分裂症患者血清瘦素水平的影响  

Metformin Addition Therapy Attenuates Serum Levels of Leptin in Schizophrenia with Olanzapine-induced Weight Gain

作　　者：潘奇[1] 陈方斌[1] 欧阳晖[1] 张艳[1] 

机构地区：[1]中国江苏省常州市解放军第102医院精神科,213003

出　　处：《中国健康心理学杂志》2014年第6期826-828,共3页China Journal of Health Psychology

摘　　要：目的：观察并分析二甲双胍对奥氮平治疗后体重增加的精神分裂症患者血清瘦素的影响。方法单一接受奥氮平治疗并出现有临床意义体重显著增加（≥7％）的精神分裂症患者，随机分组后分别加用（二甲双胍组， n＝35）或不加用（对照组，n＝35）二甲双胍（750mg/d）辅助治疗，于治疗前及治疗后4、8周末分别测定体质量指数（BMI）、血清瘦素、稳态模型评估的胰岛素抵抗指数（ HOMA-IR）。结果①二甲双胍组治疗后4、8周时，瘦素、HOMA-IR均较治疗前显著下降（ P＜0．05～0．01）；治疗8周时BMI较治疗前显著下降（P＜0．05）。对照组治疗4、8周时，BMI、瘦素、HOMA-IR与治疗前比较无显著差异；②两组治疗前及治疗后4、8周时，血清瘦素水平与BMI、HOMA-IR均有显著相关（r＝0．356～0．463，P＝0．036～0．004）；二甲双胍组治疗后4、8周时，血清瘦素治疗前后的变化值与BMI、HOMA-IR治疗前后的变化值均有显著相关（ r＝0．341～0．404，P＝0．042～0．015）。结论二甲双胍辅助治疗可显著降低奥氮平所致体重增加的精神分裂症患者血清瘦素水平，并与其对体重、胰岛素抵抗的改善有关。Objective To assess the efficacy of metformin on serum leptin levels in schizophrenic patients with weight gain induced by olanzapine .Methods Schizophrenic patients with clinically significant weight gain （≥7%） induced by olanzapine were randomly di-vided into two groups,treated with metformin（750mg/d,metformin group,n=35） or without metformin（control group,n=35） as an ad-dition therapy .The body mass index （ BMI） ,serum leptin level and homeostasis model assessment of insulin resistance index （ HOMA-IR） were measured before and 4,8 weeks after treatment.Results There was a significant decrease in serum leptin and HOMA -IR from baseline to week 4.8 （P〈0.05）and in BMI at 8 weekend （P〈0.05）in metformin group.There was no significant change of BMI , serum leptin levels and HOMA-IR from baseline to week 4,8 in control group .The serum levels of leptin was significantly correlated with BMI or HOMA-IR in both two groups at any time point of the study （r=0.356~0.463,P〈0.05）.There was a positive relation-ship between the diversify of leptin and BMI ,HOMA-IR at the time of 4,8 weeks post metformin therapy （r=0.341~0.404,P〈0.05）.Conclusion In schizophrenia patients with olanzapine-induced weight gain,metformin addition therapy is effective in attenuating serum levels of leptin ,which is related with the relief of body weight gain and insulin resistance .

关 键 词：二甲双胍 精神分裂症 体重增加 胰岛素抵抗 奥氮平 精神病学 

分 类 号：R749.3[医药卫生—神经病学与精神病学]