抗精神病药物治疗急性期体脂分布特征及其与血脂代谢相关性研究

Investigation of antipsychotic induced body fat distribution and the relationship with metabolic of blood lipids in schizophrenic patients.

目的 探讨抗精神病药物治疗急性期体脂分布特征及其与血脂代谢的关系。方法 对 4 6例入选患者采用自身配对设计 ,给予单一抗精神病药物 (APS)治疗 10周 ,检测患者治疗前后体重、体重指数 (BMI)和血脂 ,并采用结构核磁共振测定其中 4 0例患者治疗前后体脂指标 ,包括腹部皮下脂肪 (SUB)和内脏脂肪 (IAF)。结果 APS治疗前后患者体重指标差异有显著性 (P <0 0 5～P <0 0 0 0 1) ,体脂指标差异有显著性 (PSUB<0 0 5、PIAF<0 0 0 1) ,男性体脂指标变化值明显高于女性 ;血脂指标治疗前后差异有显著性 (P <0 0 1～P <0 0 0 0 1) ;治疗后体重指数(BMI)与甘油三酯 (TG)呈正相关 (r=0 391;P =0 0 14 ) ;体脂指标中IAF与低密度脂蛋白 (LDL)呈正相关 (r =0 4 38;P =0 0 1)。结论 APS治疗急性期体脂分布具腹型肥胖特征 ,男性更明显 。

Objective To investigate the effects of antipsychotic agent therapy on body fat distribution and its relationship with metabolism of blood lipids in schizophrenic patients of previously untreated patients with schizophrenia. Methods 46 Chinese Han untreated patients with schizophrenia were studied by self-controlled design. Body fat distribution was assessed by MRI in 40 of the previously untreated schizophrenic patients on hospital admission and after 10 weeks treatment with risperidone or chlorpromazine primarily. Body weight, body mass index and blood lipids were also measured for all subjects. Results Substantial diffe-rences in body mass reflecting increases in both subcutaneous and intra-abdominal fat were identified after 10 weeks antipsychotic drug treatment in the patient group(all P<0.05), with substantial increases in the male patients. The significant increase in circulating lipids was also identified(P<0.01). In addition, increased body mass index was positively correlated with triglyceride levels in plasma in the patients(r=0.341;P=0.014). The increase in intra-abdominal fat was positively correlated with the serum level of low-density lipoprotein(r=0.438;P=0.01). Conclusions The body fat distribution was characterized by the central obesity in patients receiving antipsychotic drugs, especially in male patients. Along with abdominal fat deposition, the level of serum lipids was also increased.