中国大陆地区精神分裂症患者奥氮平治疗引起体质量增加的相关因素分析

Factors associated with weight gain during six-month olanzapine therapy

目的 分析中国大陆地区精神分裂症患者奥氮平治疗期间体质量增加的相关因素.方法 采用事后分析方法,对1项多国家及地区关于奥氮平治疗的观察性研究中国大陆地区330例精神分裂症患者的临床数据进行分析.结果 奥氮平治疗6个月,中国大陆地区患者平均体质量增加（4.5±4.0）kg,145例（47.2%）患者出现有临床意义的体质量增加（CSWG）;其中,94例（29.6%）患者在治疗2个月后出现早期CSWG,其6个月时体质量增加的总体幅度（7.5 kg）大于无早期CSWG患者（2.7 kg）,二者比较差异有统计学意义（P〈0.01）.有10项因素与治疗中体质量增加相关,分别为思想沉湎于食物（5.1 kg）、晚上吃零食（5.4 kg）、需过量进食方有饱感（4.9 kg）、进食红肉（5.0 kg）、餐后有舒适的饱感（5.0 kg）、每天的连续行走量（4.9 kg）、最主要进餐场所（4.9 kg）、社交活动（5.6 kg）、性别和进餐规律性（男性5.1 kg,女性4.5 kg,进餐无规律5.0 kg）.结论 思想沉湎于食物、晚上吃零食、需过量进食方有饱感、进食红肉、餐后有舒适的饱感、每天的连续行走量、最主要进餐场所、社交活动、性别和进餐规律性与中国大陆地区精神分裂症患者奥氮平治疗期间体质量相关.

Objective To identify factors associated with weight gain during olanzapine therapy in Chinese patients with schizophrenia. Methods A post hoc analysis was conducted on data from the Chinese subgroup （n = 330） of a multinational/multiregional observational study. Results After 6 months of olanzapine therapy, the mean ± standard deviation （SD） weight change was （4. 5 ±4.0） kg and 145 （47. 2%） patients had clinically significant weight gain （CSWG, ≥7% increase from baseline）. In these patients,94 （29.6%） had early CSWG after 2 months of therapy. Patients with early CSWG had a significantly greater overall weight gain at 6 months compared to patients without early CSWG （LS mean weight gain：7. 5 kg and 2. 7 kg, respectively, P〈0. 001） . Ten factors were associated with treatment-emergent weight gain in a multivariate analysis： preoccupied thoughts with food （5. 1 kg） , evening snack consumption （5.4 kg） , taking an excessive amount of food to feel full （4.9 kg） , red meat consumption （5. 0 kg） , comfortably full sense when meal was finished （5. 0 kg） , amount of continuous walking per day （4. 9 kg） , the place where the patient took the majority of their meals （4. 9 kg） , social activity level and meal regularity （5. 6 kg） , gender and the regularity of eating （male 5. 1 kg, female 4. 5 kg,irregular eating 5. 0 kg）. Conclusion The identified factors may assist with the early identification of candidates for weight control intervention during olanzapine therapy.