双相障碍患者代谢综合征风险研究

Risk factors for metabolic syndrome in patients with bipolar disorder

目的调查双相障碍患者长期治疗中代谢综合征的风险发生率及分析可能的相关因素。方法采用横断面研究。以单用心境稳定剂或联用抗精神病药连续6月以上的门诊双相障碍患者为调查对象。采用统一问卷及实验室检测。代谢综合征诊断标准采用2004年中华医学会糖尿病分会代谢综合征标准。结果共入组128例,双相障碍患者中代谢综合征的发生率为36.7%(47例)。药物类别及用药时间与代谢综合征的发病风险有关(回归系数B值分别为-0.614,-0.797;P值分别为0.028,0.001)。结论与普通人群相比,双相障碍患者有较高的代谢综合征发病风险。用药时间越长代谢综合征的发生风险越高。联用抗精神病药能增加代谢综合征的发生率。临床上应注意监测代谢指标及对代谢异常进行干预。

Objective： To investigate the incidence of metabolic syndrome （MS） in outpatients with bipolar disorder during long - term treatment and to explore the related factors of MS. Methods： This was a cross -sectional study. Patients with bipolar disorder and treated with mood stabilizer alone or in combination with one kind of antipsychotic for more than six months were recruited. The patients were interviewed with self made questionnaire. All patients had blood tests and physical measurements. The patients were diagnosed as MS according to the criteria of 2004 Diabetes Branch of the Chinese Medical Association. Results： 128 outpatients with bipolar disorder were recruited and completed the study. 47 patients （ 36.7% ） suffered from MS. Logistic regression analysis showed that MS was correlated with the sort of drugs （ regression coefficient B = - 0. 614, P = 0. 028 ） and duration of medication （ regression coefficient B = - 0. 797, P = 0. 001 ）. Conclusion：This study indicates that the metabolic syndrome is highly prevalent in patients with bipolar disorder. The longer the drugs are taken, the higher the risk to suffer from metabolic syndrome is. Antipsychotics may increase the incidence of metabolic syndrome. Psychiatrists need to monitor the metabolic parameters and to cope with the metabolic abnormalities as early as possible.