Clinical research

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
Expand
  • 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

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.

Cite this article

Bing-fu SONG , Bin-bin Ding , Xiao-li ZHANG , Li-yun YAO . Observation of therapeutic efficacy of metformin on glucose dysregulation and dyslipidaemia induced by quetiapine in patients with schizophrenia[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(6) : 776 -780 . DOI: 10.3969/j.issn.1674-8115.2021.06.012

References

1 Owen MJ, Sawa A, Mortensen PB. Schizophrenia[J]. Lancet, 2016, 388(100390): 86-97.
2 Lipska BK, Lerman DN, Khaing ZZ, et al. Gene expression in dopamine and GABA systems in an animal model of schizophrenia: effects of antipsychotic drugs[J]. Eur J Neurosci, 2003, 18(2): 391-402.
3 张静, 闽国庆. 奥氮平联合富马酸喹硫平治疗精神分裂症的临床观察[J]. 中国药房, 2016, 27(9): 1173-1176.
4 Mehta S, Johnson ML, Chen H, et al. Risk of cerebrovascular adverse events in older adults using antipsychotic agents: a propensity-matched retrospective cohort study[J]. J Clin Psychiatry, 2010, 71(6): 689-698.
5 Lally J, MacCabe JH. Antipsychotic medication in schizophrenia: a review[J]. Br Med Bull, 2015, 114(1): 169-179.
6 Sun DL, Gu DF. Intervention and treatment of metabolic syndrome[J]. Chin J Practintern Med, 2008, 2811: 907-909.
7 董介正, 徐莲莲, 刘义, 等. 二甲双胍对奥氮平及喹硫平所致大鼠糖脂代谢紊乱的防治作用[J]. 中国药理学与毒理学杂志, 2014, 28(3): 362-366.
8 王志华, 熊强, 邹圣军. 二甲双胍治疗奥氮平所致精神分裂症患者体质量增加及糖脂代谢紊乱的疗效观察[J]. 当代医学, 2019, 25(24): 140-141.
9 郑芳芳, 陈士华, 闻传毅, 等. 喹硫平与奥氮平治疗老年器质性精神障碍的疗效及对生活质量的影响[J]. 河北医药, 2017, 39(12): 1860-1862.
10 Zahan T, Akhter N, Mullick MSI, et al. Metabolic risk factor-profile in patients on treatment with second generation antipsychotics[J]. Bangladesh Med Res Counc Bull, 2015, 41(3): 144-150.
11 Huang TL, Chen JF. Serum lipid profiles and schizophrenia: effects of conventional or atypical antipsychotic drugs in Taiwan[J]. Schizophr Res, 2005, 80(1): 55-59.
12 Ryan MC, Thakore JH. Physical consequences of schizophrenia and its treatment: the metabolic syndrome[J]. Life Sci, 2002, 71(3): 239-257.
13 姜雨微, 姜文海, 马连华, 等. 非典型抗精神病药物导致血脂异常的机制及干预[J]. 精神医学杂志, 2015, 28(6): 474-477.
14 王玲, 吕红霞, 徐记芳, 等. 不同非典型抗精神病药物对器质性精神障碍患者疗效及体质量、脂糖代谢的影响[J]. 国际精神病学杂志, 2017, 44(1): 30-32, 36.
15 朱肖飞, 陈长浩, 王钦文, 等. 利培酮、喹硫平、阿立哌唑治疗男性早期精神分裂症患者糖脂代谢的对照研究[J]. 解放军预防医学杂志, 2019, 37(7): 82-83.
16 闫芳. 二甲双胍的临床应用[J]. 现代诊断与治疗, 2010, 21(5): 285-286.
17 向伟, 陈妍, 钱时兴, 等. 二甲双胍对老年住院精神分裂症患者奥氮平治疗后体重体质量增加的干预效果[J]. 中国医师杂志, 2020, 22(4): 598-601.
18 张世应, 张书勤. 二甲双胍联合中药对奥氮平所致精神分裂症患者体质量增加及糖脂代谢紊乱的影响[J]. 现代中西医结合杂志, 2016, 25(34): 3836-3838.
Outlines

/