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Metabolic syndrome in psychiatric patients: overview mechanisms and implications

机译：精神病患者代谢综合征：概述机制和意义

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Psychiatric patients have a greater risk of premature mortality, predominantly due to cardiovascular diseases (CVDs). Convincing evidence shows that psychiatric conditions are characterized by an increased risk of metabolic syndrome (MetS), a clustering of cardiovascular risk factors including dyslipidemia, abdominal obesity, hypertension, and hyperglycemia. This increased risk is present for a range of psychiatric conditions, including major depressive disorder (MDD), bipolar disorder (BD), schizophrenia, anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), and posttraumatic stress disorder (PTSD). There is some evidence for a dose-response association with the severity and duration of symptoms and for a bidirectional longitudinal impact between psychiatric disorders and MetS. Associations generally seem stronger with abdominal obesity and dyslipidemia dysregulations than with hypertension. Contributing mechanisms are an unhealthy lifestyle and a poor adherence to medical regimen, which are prevalent among psychiatric patients. Specific psychotropic medications have also shown a profound impact in increasing MetS dysregulations. Finally, pleiotropy in genetic vulnerability and pathophysiological mechanisms, such as those leading to the increased central and peripheral activation of immunometabolic or endocrine systems, plays a role in both MetS and psychiatric disorder development. The excess risk of MetS and its unfavorable somatic health consequences justifies a high priority for future research, prevention, close monitoring, and treatment to reduce MetS in the vulnerable psychiatric patient.
机译：精神病患者过早死亡的风险较高，主要是由于心血管疾病（CVD）。令人信服的证据表明，精神疾病的特征是代谢综合征（MetS）风险增加，包括血脂异常，腹部肥胖，高血压和高血糖在内的一系列心血管疾病危险因素。一系列精神疾病的风险增加，包括重度抑郁症（MDD），躁郁症（BD），精神分裂症，焦虑症，注意力不足/多动症（ADHD）和创伤后应激障碍（PTSD）。有证据表明，剂量反应与症状的严重程度和持续时间有关，并且与精神疾病和MetS之间的双向纵向影响有关。与腹部肥胖和血脂异常有关，与高血压的相关性通常似乎更强。造成这种情况的机制是不健康的生活方式和对医疗方案的依从性差，这在精神病患者中很普遍。特定的精神药物也已显示出对增加MetS失调的深刻影响。最后，遗传易感性和病理生理机制中的多效性，例如导致免疫代谢或内分泌系统中枢和外周激活增加的机制，在MetS和精神疾病的发展中均起着作用。 MetS的过高风险及其不利的身体健康后果证明，在未来的研究，预防，密切监测和治疗中应优先考虑减少易感精神病患者的MetS。

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