二甲双胍对抗精神病药所致肥胖患者胰岛素抵抗及血清白介素-18水平的影响  

Influence of metformin on insulin resistance and serum level of interleukin-18 in obesity patients induced by antipsychotics

作　　者：朱强[1] 张文跃[1] 韩晓东[1] 顾凤华[1] 马俊峰[1] 陆忠桃 

机构地区：[1]江苏省太仓市第三人民医院精神科,215400

出　　处：《临床精神医学杂志》2015年第6期400-402,共3页Journal of Clinical Psychiatry

基　　金：苏州市科技计划(应用基础研究-医疗卫生)(SYSD2013031);太仓市科技支撑(社会发展)计划项目(TC2013SW09);太仓市卫生人才计划培养项目

摘　　要：目的:探讨二甲双胍对抗精神病药所致肥胖患者胰岛素抵抗及血清白介素-18(IL-18)水平的影响。方法:对44例抗精神病药所致肥胖患者(肥胖组)给予二甲双胍治疗12周,监测治疗前后的体质量、体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)及血清IL-18水平;以27例非肥胖患者(非肥胖组)和47名正常人(正常对照组)作为对照。结果:治疗前肥胖组HOMA-IR、血清IL-18水平高于非肥胖组(Z=-5.05,P<0.001;Z=-2.78,P<0.01)及正常对照组(Z=5.98,Z=6.68;P均<0.001);非肥胖组血清IL-18水平高于正常对照组(Z=4.58,P<0.001)。治疗后肥胖组体质量及BMI均有明显下降(Z=2.07,Z=2.13;P均<0.05);HOMA-IR虽有明显下降(Z=2.74,P<0.01)但仍高于非肥胖组及正常对照组(Z=-4.01,Z=4.73;P均<0.001);IL-18水平显著下降(Z=5.48,P<0.001)并低于非肥胖组(Z=3.42,P<0.01),但仍高于正常对照组(Z=3.59,P<0.01)。HOMA-IR与IL-18水平治疗前后均无相关(r=0.108,r=0.034;P均>0.05);HOMA-IR变化值与IL-18水平变化值也无相关(r=0.122,P>0.05)。结论:二甲双胍能改善抗精神病药所致肥胖患者的胰岛素抵抗,降低血清IL-18水平。Objective：To explore the influence of metformin on insulin resistance and serum level of interleukin-18（ IL-18） in obesity patients induced by antipsychotics.Method：44 obesity patients induced by antipsychotics（ obesity group） were treated by metformin for 12 weeks.Body weight,body mass index（ BMI）,homeostasis model assessment of insulin resistance（ HOMA-IR） and serum level of IL-18 in obesity group were detected before and after 12-week metformin treatment.27 non-obesity patients（ non-obesity group） and 47 normal subjects（ normal group） were collected as controls.Results：Before treatment,HOMA-IR and serum level of IL-18 in obesity group were higher than those in non-obesity group（ Z =-5.05,P〈0.001;Z =-2.78,P〈0.01） and normal group（ Z = 5.98,Z = 6.68;all P〈0.001）.Serum level of IL-18 in non-obesity group was also higher than that in normal group（ Z = 4.58,P〈0.001）.After 12-week treatment,body weight and BMI in obesity group were decreased（ Z = 2.07,Z = 2.13;all P〈0.05）.HOMA-IR in obesity group was alleviated（ Z =2.74,P〈0.01）,but still higher than that in non-obesity group and normal group（ Z =-4.01,Z = 4.73;all P〈0.001）.Serum level of IL-18 in obesity group was decreased significantly（ Z = 5.48,P〈0.001）.Serum level of IL-18 after treatment in obesity group was lower than that in non-obesity group（ Z = 3.42,P〈0.01）,but still higher than that in normal group（ Z = 3.59,P〈0.01）.Before and after treatment,no relationship was existed between HOMA-IR and serum level of IL-18 in obesity group（ r = 0.108,r = 0.034;all P〉0.05）.There was also no relationship between change of HOMA-IR and change of serum level of IL-18 in obesity group（ r = 0.122,P〉0.05）.Conclusion：Metformin can alleviate insulin resistance and decrease serum level of IL-18 in obesity patients induced by antipsychotics.

关 键 词：二甲双胍 抗精神病药 肥胖 胰岛素抵抗 白介素 

分 类 号：R749[医药卫生—神经病学与精神病学]