精神药物的不良反应(二) 药源性肥胖患者血清瘦素和脂联素水平检测

A study of serum level of leptin and adiponectin in obesity patients induced by antipsychotics

目的:探讨抗精神病药药源性肥胖患者血清瘦素和脂联素的水平及相关性。方法:选择21例药源性肥胖的住院患者(A组),20例首发精神分裂症患者(B组),20名健康体检人员作为对照组(C组),采用放射免疫法检测各组血清瘦素和脂联素水平,并分析各组血清瘦素及脂联素与体质量指数(BMI)相关性。结果:A组血清瘦素水平(13.3±8.2)μg/L高于B组(7.6±1.2)μg/L和C组(4.6±0.8)μg/L(P<0.05),而血清脂联素水平(3.5±2.9)mg/L低于B组(9.1±2.2)mg/L和C组(12.2±3.5)mg/L(P<0.05);B组和C组血清瘦素和脂联素水平差异无统计学意义(P>0.05)。A组血清瘦素水平与BMI呈显著正相关(r=0.390,P<0.01),而血清脂联素水平则与BMI呈显著负相关(r=-0.357,P<0.01)。结论:抗精神病药药源性肥胖患者血清瘦素水平升高及脂联素水平降低与其体内存在瘦素抵抗和脂联素合成反馈调节机制障碍有关。

Objective ：To study serum level of leptin（LP） and adiponectin（AP） and their relationship in obesity patients with schizophrenia induced by antipsychotics. Method：Obesity inpatients with schizophrenia induced by antipsychotics （ group A, n = 21 ）, first - episode patients with schizophrenia （ group B, n = 20） and healthy controls by physical examination （group C, n = 20）. The serum level of LP and AP were measured by radioimmunoassay in all the subjects. The relationship between the body mass index （BMI） and the serum level of LP or AP were analyzed in the three groups, respectively. Results： The serum level of LP and AP of group A was higher and lower, respectively, compared with those in group B and group C LP （13.3± 8.2 ）μg/L vs （7.6 ±1.2 ）μg/L and （13.3 ±8.2）μg/L vs （4.6 ±0.8）μg/L （P〈0.05）;AP （3.5 ±2.9）mg/L vs （9.1 ±2.2 ） mg/L and （ 3.5±2.9 ） mg/L vs （ 12.2 ± 3.5 ） mg,/L （ P 〈 0.05 ）. The was no significant difference between group B and group C. The serum level of LP of group A was positive correlated with BMI （ r = 0. 390, P 〈 0. 01 ）. While the serum level of AP of group A was negatively correlated with BMI （ r = - 0. 357, P 〈 0. 01 ）. Conclusion：The higher serum level of LP and lower serum level of AP in obesity patients with schizophrenia induced by antipsychotics were related to the LP resistance and the disturbance of synthesis-feedback regulation in AP.