上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2021 , Vol. 41 >Issue 6: 776 - 780

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.06.012

论著 · 临床研究

二甲双胍对喹硫平致精神分裂症患者糖脂代谢紊乱的疗效

  • 宋兵福 ,
  • 丁彬彬 ,
  • 张晓丽 ,
  • 姚莉韵
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  • 1.上海市杨浦区精神卫生中心普通精神科，上海 200093
    2.上海市虹口区精神卫生中心检验科，上海 200083
    3.上海市杨浦区精神卫生中心检验科，上海 200093
    4.上海交通大学基础医学院药物化学与生物信息学中心，上海 200025
宋兵福（1973—），男，副主任医师，学士；电子信箱：bfsong@sina.cn|宋兵福（1973—），男，副主任医师，学士；电子信箱：bfsong@sina.cn

网络出版日期: 2021-06-29

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Observation of therapeutic efficacy of metformin on glucose dysregulation and dyslipidaemia induced by quetiapine in patients with schizophrenia

  • Bing-fu SONG ,
  • Bin-bin Ding ,
  • Xiao-li ZHANG ,
  • Li-yun YAO
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  • 1.Department of General Psychiatry, Shanghai Yangpu District Mental Health Center, Shanghai 200093, China
    2.Department of Clinical Laboratory, Shanghai Hongkou District Mental Health Center, Shanghai 200083, China
    3.Department of Clinical Laboratory, Shanghai Yangpu District Mental Health Center, Shanghai 200093, China
    4.Medicinal Chemistry and Bioinformatics Center, Shanghai Jiao Tong University College of Basic Medical Sciences, Shanghai 200025, China

Online published: 2021-06-29

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摘要

目的·观察二甲双胍（metformin，MF）对喹硫平所致精神分裂症（schizophrenia，SZ）患者糖脂代谢紊乱的疗效。方法·纳入上海市虹口区精神卫生中心和上海市杨浦区精神卫生中心的83例SZ患者，随机分为治疗组（MF组）38例和对照组45例。对照组仅口服喹硫平治疗，MF组在喹硫平口服基础上，采用MF辅助治疗。于治疗前及治疗后第2、4、8周检测2组患者的葡萄糖（glucose，GLU）、总胆固醇（total cholesterol，TC）、三酰甘油（triacylglycerol，TAG）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、小而密低密度脂蛋白胆固醇（small density low-density lipoprotein cholesterol，sd-LDL-C）和同型半胱氨酸（homocysteine，HCY）。结果·治疗前对照组与MF组比较，患者的年龄、病程、体质量指数、GLU、TC、TAG、HDL-C、LDL-C、sd-LDL-C和HCY检测结果差异均无统计学意义。治疗8周后，对照组所有实验室指标检测结果较治疗前均升高；MF组GLU、TC、TAG、LDL-C、sd-LDL-C和HCY水平较治疗前均下降，但HDL-C水平较治疗前升高。治疗8周后2组HDL-C水平的差异无统计学意义（P=0.247），其他实验室指标的组间差异均有统计学意义（P<0.05），MF组的降糖、降脂效果显著优于对照组。方差分析结果显示，治疗4、8周后，对照组HDL-C水平与治疗前比较显著升高，差异有统计学意义（P=0.005，P=0.003）；对照组LDL-C水平在治疗2、4、8周后与治疗前比较显著升高（P=0.005，P=0.019，P=0.026）；对照组其他实验室指标与治疗前比较差异均无统计学意义。治疗2、4、8周后，MF组GLU、TC、TAG和sd-LDL-C水平与治疗前比较显著下降；治疗4、8周后，MF组LDL-C和HCY水平与治疗前比较显著降低；治疗2周后MF组HDL-C水平与治疗前比较显著升高，但治疗4、8周后检测结果与治疗前比较差异无统计学意义。结论·对喹硫平治疗后致糖脂代谢紊乱的SZ患者实施MF辅助治疗，可显著降低患者血糖水平，改善患者血脂代谢。

关键词： 喹硫平; 精神分裂症; 糖脂代谢紊乱; 二甲双胍

本文引用格式

宋兵福 , 丁彬彬 , 张晓丽 , 姚莉韵 . 二甲双胍对喹硫平致精神分裂症患者糖脂代谢紊乱的疗效[J]. 上海交通大学学报（医学版）, 2021 , 41(6) : 776 -780 . DOI: 10.3969/j.issn.1674-8115.2021.06.012

Abstract

Objective

·To investigate the therapeutic efficacy of metformin (MF) on glucose dysregulation and dyslipidaemia induced by quetiapine in patients with schizophrenia (SZ).

Methods

·A total of 83 SZ patients from Shanghai Hongkou District Mental Health Center and Shanghai Yangpu District Mental Health Center were enrolled, and randomly divided into treatment group (MF group, n=38) and control group (n=45). The control group received oral quetiapine therapy, and the MF group additionally received metformin on the basis of oral quetiapine therapy. The serum levels of glucose (GLU), total cholesterol (TC), triacylglycerol (TAG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), small density low-density lipoprotein cholesterol (sd-LDL-C) and homocysteine (HCY) were determined before treatment and 2, 4 and 8 weeks after treatment.

Results

·There were no statistic differences in ages, courses, body mass index, the levels of GLU, TC, TAG, HDL-C, LDL-C, sd-LDL-C and HCY between the control and MF group before treatment (all P>0.05). After 8 weeks of treatment, levels of all biomarkers elevated in the control group. The levels of GLU, TC, TAG, LDL-C, sd-LDL-C and HCY were lower after treatment, and the level of HDL-C elevated higher in the MF group. The variations of levels of HDL-C after treatment showed statistically no significant difference between the two groups (P=0.247), while statistical differences existed in other biomarkers, which indicated that the glucose-lowering and lipid-lowering efficacies in the MF group were significantly better than those in the control group. The analysis of variance suggested that, in the control group, the level of HDL-C elevated significantly after 4 and 8 weeks′ treatment, having statistical differences (P=0.005 and P=0.003). The level of LDL-C elevated significantly after 2, 4 and 8 weeks′ treatment (P=0.005, P=0.019 and P=0.026), and no statistical differences were observed in other biomarkers. In the MF group, the levels of GLU, TC, TAG and sd-LDL-C were lower 2, 4 and 8 weeks after treatment, the levels of LDL-C and HCY descended 4 and 8 weeks after treatment, and no statistical differences were observed in other biomarkers. The level of HDL-C was higher after 2 weeks, treatment, but showed statistically no significant differences 4 and 8 weeks after treatment, compared to the level determined before treatment.

Conclusion

·Administration of MF in the SZ patients having glucose dysregulation and dyslipidaemia induced by quetiapine can significantly lower serum level of GLU, and improve the serum lipid profiles.

Key words： quetiapine; schizophrenia (SZ); glucosedysregulation and dyslipidaemia; metformin (MF)

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