空腹血糖异常的精神分裂症患者临床及代谢特征分析

Clinical and metabolic features in schizophrenia inpatients with different thresholds of fasting glucose

目的 探讨不同空腹血糖状态的精神分裂症患者临床特征及其糖脂代谢的差异。方法调查广州市精神病医院405例住院时间6个月或以上的患者，记录一般资料、病史、服药情况，测量身高、体重、腹围、臀围，测定空腹血糖（FPG）、血脂指标。按FPG结果分为正常FPG组、空腹血糖受损（IFG）组及2型糖尿病组。比较3组的临床特征、生化指标及与代谢综合征（MS）发生的关系。结果长期住院精神分裂症患者中IFG的发生率为11．60％（47／405），2型糖尿病患病率为22．22％（90／405）。IFG组及2型糖尿病组较正常FPG组腹围、FPG、TG、HDL—C高[正常FPG组、IFG组、2型糖尿病组分别为（85．5±10．5）、（89．8±10．2）、（93．4±9．3）cm，（4．62±0．47）、（5．99±0．41）、（6．46±1．90）mmol／L，（1．75±1．09）、（2．25±1．10）、（2．25±1．12）mmol／L，（1．40±0．32）、（1．31±0．24）、（1．26±0．25）mmol／L]，患MS者较多[正常FPG组、IFG组、2型糖尿病组分别为49例（18．3％）、16例（34．0％）、21例（23．3％）]（均P〈0．05）。Logistic回归分析示女性是MS的危险因素（OR=2．22，95％CI：1．39—5．55）。IFG组及2型糖尿病组发生MS风险均增高。结论长期住院精神分裂症患者出现血糖异常较一般人群高；IFG患者存在过度肥胖、脂代谢紊乱及高代谢综合征风险。

Objective To investigate clinical features and metabolic indexes of schizophrenia inpatient with different fasting glucose level. Methods Inpatients of Guangzhou Psychiatry Hospital were divided into normal fasting plasma glucose （FPG）group, impaired fasting glucos （IFG）group and type 2 mellitus group according to the fasting glucose. Clinical features and metabolic indexes of them were staticstically analyzed. Results The IFG prevalence of schizophrenia inpatients was 11.60% and the type 2 mellitus was 22.22%. The patients with IFG and mellitus had higher frequency of dyslipidemia and metabolic syndrome（ P 〈0.05）. Logistic regression analysis indicated that female, IFG and type 2 mellitus were rick factors of metabolic syndrome （ P 〈 0.01 ）. Conclusion The patients with IFG have high risk of suffering from obesity, dyslipidemia and metabolic syndrome.