双相情感障碍躁狂相患者糖脂代谢相关因素分析

Analysis of factors relevant to glucose and lipid metabolism of patients with bipolar disorder at manic phase

目的了解双相障碍患者糖脂代谢状况并探索相关影响因素。方法应用双相躁狂疾病路径调查问卷(BIPAS)筛选3 906例双相障碍患者,在本研究中入组2 229例患者。结果患者的糖脂代谢指标明显异常,三酰甘油、高密度脂蛋白、低密度脂蛋白水平与性别有关(P<0.05);不同临床相(首次发作期、复发期和稳定期)患者的三酰甘油、低密度脂蛋白及空腹血糖水平的差异有统计学意义(P<0.05);接受不同药物治疗方案(心境稳定剂联合抗精神病药物与心境稳定剂联合非抗精神病药物)患者间的三酰甘油水平的差异有统计学意义(P<0.05);不同病程、首次发作类型及疾病发作次数的患者糖脂代谢水平的差异有统计学意义(P<0.05)。结论双相障碍患者的糖脂代谢指标明显紊乱,且相关指标的差异与患者的性别、双相障碍的临床相、治疗方案及病程、首发病类型及发病次数有关。

Objective To investigate the glucose and lipid metabolism of patients with bipolar disorder and relevant influencing factors. Methods A total of 3 906 patients with bipolar disorder were screened by the questionnaire of Bipolar Mannia Pathway Survey （BIPAS） and 2 229 of them were enrolled. Results The levels of glucose and lipid of patients were significantly abnormal and the levels of triglyceride （TG）, highdensity lipoprotein （HDL）, and low-density lipoprotein （LDL） were correlated with the gender （P 〈0.05）. The differences of levels of TG, LDL, and fasting blood glucose （FBG） of patients at different clinical phases （first episode phase, relapse phase, and stationary phase） were statistically significant （P 〈 0.05）. The differences of the TG level of patients who underwent different drug therapies （ mood stabilizers combined with antipsychotics and stabilizers combined with non-antipsychotics） were statistically significant （P 〈0.05）. The differences of the levels of glucose and lipid of patients with different course of disease, types of first episode, and number of attacks were statistically significant （ P 〈 0.05）. Conclusion The levels of glucose and lipid of patients with bipolar disorder are significantly abnormal. The differences of levels of glucose and fipid correlate with the gender, clinical phase of bipolar disorder, treatment, course of disease, type of first episode, and number of attacks.