上海市社区精神分裂症患者超重或肥胖的相关因素分析

【目的】了解上海市社区精神分裂症患者超重或肥胖的流行情况,并分析其相关因素。【方法】采取分层整群抽样方法,对2020年自愿参加国家基本公共卫生服务免费健康体检的社区精神分裂症患者的一般情况、体格检查、实验室检查资料进行分析。【结果】纳入分析的3200例社区精神分裂症患者中,超重者占36.75%,肥胖者占17.19%。多因素logistic回归分析结果显示,年龄40~<60岁(OR=1.333,95%CI:1.030~1.724)、服用第一代抗精神病药物(OR=1.413,95%CI:1.112~1.796)、服用第二代抗精神病药物(OR=1.573,95%CI:1.288~1.921)、血压正常高值(OR=1.549,95%CI:1.245~1.927)、血压异常高值(OR=2.824,95%CI:2.204~3.619)、丙氨酸氨基转移酶(ALT)升高(OR=1.874,95%CI:1.386~2.535)、空腹血糖(FBG)升高(OR=1.270,95%CI:1.066~1.513)以及三酰甘油(TG)升高(OR=1.652,95%CI:1.335~2.044)是精神分裂症患者超重或肥胖的相关因素。【结论】上海市社区精神分裂症患者超重或肥胖检出率较高。年龄40~<60岁、服用第一代及第二代抗精神病药物、血压≥120/80 mmHg、ALT升高、FBG升高以及TG升高与精神分裂症人群的超重或肥胖相关。基层医疗卫生机构医护人员应在每年健康体检的基础上,加强对精神分裂症患者中超重或肥胖高危人群的关注,以提供个性化健康指导。

[Objective]To investigate the prevalence of overweight or obesity in community patients with schizophrenia in Shanghai and to explore the related factors.[Methods]Stratified cluster sampling method was used and the general condition,physical examination and laboratory examination data of patients with schizophrenia who voluntarily participated in 2020 free health examination of National Basic Public Health Service were analyzed.[Results]A total of 3200 patients were included into the study,and the prevalence of overweight and obesity was 36.75%and 17.19%,respectively.Multivariate logistic regression analysis indicated that age between 40 and 60(OR=1.333,95%CI:1.030-1.724),intake of first-generation antipsychotics(OR=1.413,95%CI:1.112-1.796),intake of second-generation antipsychotics(OR=1.573,95%CI:1.288-1.921),high-normal blood pressure(OR=1.549,95%CI:1.245-1.927),high-abnormal blood pressure(OR=2.824,95%CI:2.204-3.619),elevated ALT(OR=1.874,95%CI:1.386-2.535),elevated FBG(OR=1.270,95%CI:1.066-1.513),and elevated TG(OR=1.652,95%CI:1.335-2.044)were the related factors that associated overweight or obesity in patients with schizophrenia.[Conclusion]Overweight and obesity are highly prevalent among community patients with schizophrenia in Shanghai.Age between 40 and 60,taking first-generation and second-generation antipsychotics,blood pressure higher than 120/80 mmHg,elevated ALT,elevated FBG,and elevated TG are associated with overweight or obesity in patients with schizophrenia.To provide personalized health guidance,medical staff in primary health care institutions should pay more attention to high-risk groups of overweight and obesity in schizophrenia patients at annual physical examination.