二甲双胍对奥氮平所致肥胖的精神分裂症患者内脏脂肪素的影响  

Effect of metformin on visfatin in olanzapine-induced obese schizophrenia patients

作　　者：阎同军 高志勤 蔡占魁 屠莉 谢文娇 潘园园 张露元 张瑞 徐乐平 禚传君[2] YAN Tong-jun;GAO Zhi-qin;CAI Zhan-kui;TU Li;XIE Wen-jiao;PAN Yuan-yuan;ZHANG Lu-yuan;ZHANG Rui;XU Le-ping;ZHUO Chuan-jun(Department of Psychiatry,The 904th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army,Changzhou 213003,China)

机构地区：[1]联勤保障部队第九〇四医院精神科,常州213003 [2]天津市安定医院精神科

出　　处：《临床精神医学杂志》2024年第3期183-186,共4页Journal of Clinical Psychiatry

基　　金：国家自然科学基金面上项目(81871052)。

摘　　要：目的:观察二甲双胍对服用奥氮平导致肥胖的精神分裂症患者内脏脂肪素的影响,分析其与二甲双胍降低患者体质量作用关系。方法:奥氮平治疗过程中出现肥胖的精神分裂症患者随机数法分组,分别接受二甲双胍(二甲双胍组30例)、安慰剂(安慰剂组30例)治疗,疗程12周。在治疗前、治疗12周时,测定患者血清内脏脂肪素、体质量指数(BMI)、腰围(WC)。结果:治疗12周末时,二甲双胍组患者内脏脂肪素降低(t=2.832,P<0.01)的同时,BMI、WC也较治疗前降低(分别t=2.098、t=3.868,P均<0.05、0.001);安慰剂组患者血清内脏脂肪素、BMI、WC治疗前后变化不显著(P均>0.05)。二甲双胍组治疗前后脂肪素、BMI、WC的下降值,均显著高于安慰剂组(分别t=3.403、t=6.204、t=3.958,P均<0.001)。二甲双胍组治疗前后内脏脂肪素的下降值,与BMI、WC下降值正相关(分别r=0.388,P<0.05;r=0.476,P<0.01)。结论:奥氮平致肥胖患者接受二甲双胍治疗后,内脏脂肪素水平下降,并可能与其降低患者体质量、特别是腹部脂肪量的作用有关。Objective:To investigate the effects of metformin on visfatin in olanzapin-induced obese schizophrenia and to explore its relationships with the effects on body fat.Method:Randomized schizophrenia outpatientswith olanzapine-induced obese were assigned to metformin(metformin group,n=30)or placebo(placebo group,n=30)treatment for 12 weeks.The serum visfatin,body mass index(BMI),waist circumstance(WC)were measured at baseline and the end of study.Results:Significantly decreased serum visfatin(t=2.832,P<0.01),BMI(t=2.098,P<0.05),and WC(t=3.868,P<0.001)were found in metformin group after 12 weeks treatment.No significantly changes of visfatin,BMI or WC were observed(all P>0.05)in placebo group.Analyses showed that the decrease of serum visfatin,BMI,and WC were more seriously in metformin group than that in placebo group(t=3.403,t=6.204,t=3.958;all P<0.001).And the changes of serum visfatin had positively correlations with the changes of BMI or WC(r=0.388,P<0.05;r=0.476,P<0.01)in metformin group.Conclusion:It is suggested that metformin might down-regulate the level of serum visfatin,which should be one of mechanisms of its improvement on obese.

关 键 词：精神分裂症 二甲双胍 奥氮平 内脏脂肪素 肥胖 

分 类 号：R749.3[医药卫生—神经病学与精神病学]