在第一发精神病中葡萄糖,胰岛素和脂质障碍的变化:元分析
Toby Pillinger1,2,3, Robert A McCutcheon1,2,3, Oliver D Howes2,3,4,5
1Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK.
Psychological medicine
|July 14, 2023
概括
第一发精神病 (FEP) 患者的代谢变异性比对照组更大,表明代谢失调风险更高的子组. 女性性别和严重的症状加剧了代谢结果,强调了需要有针对性的监测.
科学领域:
- 神经科学是一个神经科学.
- 代谢精神病学 代谢精神病学
- 临床心理学 临床心理学
背景情况:
- 第一发精神病 (FEP) 与代谢变化有关,但这些变化的异质性和代谢失调风险较高的潜在患者亚组仍然不清楚.
- 在未服用过抗精神病药物的FEP患者中研究代谢变异性对于理解疾病异质性和识别有风险的个体至关重要.
研究的目的:
- 为了研究抗精神病前的FEP患者与对照者的代谢参数变异性.
- 为了确定具有明显代谢特征的FEP患者的潜在子组.
- 探索FEP中代谢变化的调节者.
主要方法:
- 使用变化系数比率 (CVR) 的方差元分析.
- 在FEP和对照中对代谢参数 (葡萄糖,胰岛素,脂质,HbA1c) 的比较.
- 超回归来分析像人口统计学和精神病理学这样的管理者.
主要成果:
- 在FEP患者中,禁食葡萄糖,OGTT后葡萄糖,禁食胰岛素,胰岛素抵抗,HbA1c,总胆固醇,LDL和HDL的变化更大.
- 在FEP中平均葡萄糖,胰岛素,胰岛素抵抗和甘油三水平升高.
- 在FEP中降低了平均总胆固醇和HDL.
- 增加症状严重程度和女性性别与较差的代谢结果相关.
结论:
- 在FEP患者中更大的代谢变异性表明具有不同程度的代谢失调的不同亚组,可能增加对代谢综合征的脆弱性.
- 识别代谢变化的决定因素是早期检测高危患者的关键.
- 女性性别和严重的精神病理是影响代谢结果的重要因素,在临床实践中需要量身定制的代谢监测策略.
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