双相障碍与首发精神分裂症患者糖脂代谢的对照研究  

The comparison of glycolipids metabolism between patients with bipolar disorder and first-episode schizophrenia

作　　者：于健瑾[1] 陈科[1] 付卫红[1] 张荣珍[1] 尹璐[1] 高岚[1] 陈大春[1] YU Jian-jin;CHEN Ke;FU Wei-hong;ZHANG Rong-zhen;YIN Lu;GAO Lan;CHEN Da-chun(Beijing Huilongguan Hospital,Beijing 100096,China)

机构地区：[1]北京回龙观医院,北京大学回龙观临床医学院,100096

出　　处：《临床精神医学杂志》2020年第3期159-163,共5页Journal of Clinical Psychiatry

基　　金：首都卫生发展科研专项项目(首发2018-2-2131)。

摘　　要：目的:比较双相障碍与首发精神分裂症患者糖脂代谢相关指标的差异。方法:纳入2014年4月至2016年10月符合美国《精神障碍诊断与统计手册》第4版(DSM-IV)诊断标准的急性期双相障碍患者150例、首发精神分裂症患者102例,并入组性别、年龄、受教育程度匹配的正常对照者156名。采用氧化酶法测定入组者的血浆糖脂代谢参数,并计算体质量指数(BMI)、腰臀比(WHR)、稳态模型评估胰岛素抵抗指数(HOMA-IR)。结果:双相障碍组BMI高于精神分裂症组,空腹血糖(FG)、总胆固醇(TC)、高密度脂蛋白(HDL)水平低于精神分裂症组(P<0.05或P<0.01);BMI、HDL、三酰甘油(TG)高于正常对照组,TC、低密度脂蛋白(LDL)水平低于正常对照组(P<0.05或P<0.01)。精神分裂症组FG、TC、HDL水平高于正常对照组,WHR低于正常对照组(P<0.01)。双相障碍组年龄与FG、TC、LDL水平呈正相关;受教育年限与FG、TC水平呈负相关;总病程与FG水平呈正相关(P<0.05或P<0.01)。精神分裂症组年龄与FG、HDL、HOMA-IR呈正相关(P<0.05或P<0.01)。结论:双相障碍患者易出现脂类代谢异常,首发精神分裂症患者易出现糖脂异常;年龄是糖脂代谢异常的影响因素。Objective:To compare the differences of glucose and lipid metabolism in patients with bipolar disorder and first-episode schizophrenia.Method:150 patients with acute bipolar disorder and 102 patients with first-episode schizophrenia who met the diagnostic criteria of the American Diagnostic and Statistical Manual of Mental Disorders(DSM-IV)from April 2014 to October 2016 were compared with 156 normal controls matched by gender,age and education level.The glucose and lipid metabolism parameters were determined by oxidase assay and body mass index(BMI),waist-hip ratio(WHR)and insulin resistance of Homeostasis model assessment(HOMA-IR)were calculated.Results:Compared with the schizophrenia group,bipolar disorder group has higher BMI,and lower fasting glucose(FG),total cholesterol(TC)and high density lipoprotein(HDL)(P<0.05 or P<0.01).Compared with the nornal control group,the bipolar disorder group has higher BMI,HDL and triglyceride(TG),and lower TC and low density lipoprotein(LDL)(P<0.05 or P<0.01).Comprared with the normal control group,the schizophrenia group has higher FG,TC and HDL,and lower WHR(P<0.01).In the bipolar disorder group,the age was positively correlated with FG,TC,LDL;education years were negatively correlated with FG and TC;the total course of disease was positively correlated with FG(P<0.05 or P<0.01).In the schizophrenia group,the age was positively correlated with FG,HDL and HOMA-IR(P<0.05 or P<0.01).Conclusion:Patients with bipolar disorder have a high risk of lipid metabolism disorder,and patients with first-episode schizophrenia are prone to be abnormal on the glycolipids metabolism.Age is the risk factor of glycolipids metabolism disorder.

关 键 词：双相障碍 首发精神分裂症 糖脂代谢 胰岛素抵抗 

分 类 号：R749[医药卫生—神经病学与精神病学]