长期使用抗精神病药患者血清游离脂肪酸水平与有关因素研究

Study of serum free fatty acids level in patients treated by antipsychotics for long-term and its related factors

目的:探讨长期(1年以上)使用抗精神病药患者的血清游离脂肪酸(FFAs)水平,及其与空腹血糖和胰岛素抵抗之间的关系。方法:调查308例长期使用抗精神病药住院患者,用比色法检测患者空腹血清FFAs,用放射免疫法测定患者血清胰岛素和瘦素。结果:与长期使用抗精神病药有关的体质量(体重)增加或肥胖、糖耐量降低和糖尿病患者的血清FFAs水平显著高于对照组(P值分别为0.04,0.01和0.022),且与空腹血糖、胰岛素抵抗均呈显著正相关(P值分别为0.005和0.04)。结论:长期使用抗精神病药的精神分裂症患者的高血清FFAs水平影响患者的糖代谢,并参与胰岛素抵抗乃至糖尿病的发生,是代谢紊乱综合征的重要特征之一。

Objective：To investigate the level of serum free fatty acids （FFAs） in sehizophrenic patients treated by antipsychotics for a long period of time （more than 1 year） ,and explore the associations between serum FFAs and fasting blood glucose and insulin resistance. Method：308 schizophrenic inpatients were recruited into this study. Serum FFAs level was measured with colorimetry. Serum insulin and leptin were measured with radioimmunoassay. Results：The serum FFAs level in schizophrenic patients treated by antipsychotics for long-term was elevated significantly, espeeially in weight gain or obesity, impaired glucose tolerance and diabetes mellitus（ P value： 0.04, 0.01 and 0. 022 respectively）, and it had remarkable positive correlation with fasting blood glucose and insulin resistance（ P val- ue：0.005 and 0.04 respectively）. Conclusion：The elevated FFAs level in schizophrenic patients treated by antipsychotics for long-term would affect blood glucose metabolism, even play an important role in insulin resistance and diabetes mellitus, and was also one of important traits of metabolic syndrome.