利培酮短期治疗的男性精神分裂症患者催乳素水平对胰岛素敏感性的影响

Effects of prolactin level on insulin sensitivity of male schizophrenic patients in short-time risperidone treatment

目的初步探讨利培酮短期治疗的男性精神分裂症患者催乳素水平对胰岛素敏感性的影响。方法将符合入组标准的51例利培酮治疗2~6周的住院精神分裂症患者依据催乳素水平分为A组(催乳素≥800 mIU·L^(-1))27例和B组(催乳素<800 mIU·L^(-1))24例,比较两组的胰岛素敏感性指标和体重指数(BMI);依据BMI分为正常体重组(BMI 18.5~23.9 kg·m^(-2))29例和超重组(BMI≥24 kg·m^(-2))22例,比较两组的血清催乳素和胰岛素敏感性指标。结果 A、B两组空腹胰岛素(FINS)、稳态模型评估胰岛素抵抗指数(HONA-IR)、定量胰岛素敏感性检测指数(QUICKI)均无显著差异(P>0.05)。正常体重组与超重组的催乳素水平无显著差异(P>0.05);超重组FINS、HOMA-IR高于正常体重组(P<0.01),超重组QUICKI低于正常体重组(P<0.01)。结论利培酮短期治疗后的男性精神分裂症患者中体重超重者胰岛素敏感性降低,而催乳素水平不影响患者的体重及胰岛素敏感性。

AIM To study the effects of prolactin level on insulin sensitivity of male patients with schizophrenia in short- time risperidone treatment. METHODS A total of 51 schizophrenic inpatients treated with risperidone 2 - 6 week were divided into two groups based on their prolactin level： A group （prolactin ≥ 800 mIU.L-1, n = 27） and B group （prolactin 〈 800 mlU.L-1, n = 24）, and insulin sensitivity and body mass index （BMI） of the two groups were compared. The subjects were divided into two groups based on their BMI： normal weight group （BMI： 18.5 - 23.9 kg.m-2, n = 29） and overweight group （BMI ≥ 24 kg-m-2, n = 22）, and prolactin and insulin sensitivity of the two groups were compared. RESULTS There were no significant differences in fasting insulin （FINS）, homeostatic model assessment insulin resistance （HOMA- IR） and quantitative insulin sensitivity check index （QUICKI） between A and B group （P 〉 0.05）. There was no significant difference in prolactin between normal weight group and overweight group （P 〉 0.05）. The overweightgroup showed higher FINS and HOMA-IR （P 〈 0.01） and lower QUICKI （P 〈 0.01） comparison with the normal weight group. CONCLUSION Overweight is associated with the decreased insulin sensitivity in schizophrenic patients with 2 - 6 weeks risperidone treatment. Prolactin did not affect the insulin sensitivity and weight.