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首页> 外文期刊>The journal of clinical psychiatry >Hyperlipidemia in Persons Using Antipsychotic Medication: A General Population-Based Birth Cohort Study.
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Hyperlipidemia in Persons Using Antipsychotic Medication: A General Population-Based Birth Cohort Study.

机译：使用抗精神病药物的人的高脂血症：一项基于人群的一般出生队列研究。

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BACKGROUND: Shortly after phenothiazines were introduced, they were found to elevate serum triglyceride and total cholesterol levels. During the past decade, an increasing body of literature has also documented this effect in atypical antipsychotics. Previous studies of antipsychoticassociated hyperlipidemias are based on clinical samples, mostly from case series. We studied the prevalence of hyperlipidemia in subjects who did and did not take antipsychotic medication in a prospective, general population-based birth cohort. METHOD: The study sample consisted of 5654 members of the unselected Northern Finland 1966 Birth Cohort who participated in the 1997-1998 clinical examination at 31 years of age. Blood samples were taken after an overnight fast, and serum total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride levels were determined. Health habits and other possible correlates for hyperlipidemia were assessed using a questionnaire. The sample was analyzed in 4 categories according to use of antipsychotic medication: (1) atypical, (2) typical, (3) atypical and typical (for the 3 antipsychotic categories, total N = 45), and (4) no antipsychotic medication (N = 5609). Nonparametric tests and multiple logistic regression analysis were used to measure the effect of antipsychotics on serum lipids. RESULTS: High lipid levels were found in persons treated with both atypical and typical medication (mean total cholesterol = 233 mg/dL, mean triglycerides = 163 mg/dL). Mean total cholesterol and triglycerides were also high in subjects who used only typical medication (215 mg/dL and 148 mg/dL, respectively). The prevalence of hypercholesterolemia, high LDL cholesterol, and hypertriglyceridemia was high in persons using antipsychotic medication (31.1%, 20.0%, and 22.2%, respectively) compared with persons not using such medication (12.2%, 10.2%, and 7.0%, respectively). After we adjusted for risk factors for hyperlipidemia (sex, diet, waist circumference, physical exercise, smoking, and alcohol consumption), the results of logistic regression analysis showed that in persons treated with antipsychotic medication the risk of hypercholesterolemia was 2.8 (95% CI = 1.4 to 5.6); of hypertriglyceridemia, 2.3 (95% CI = 1.0 to 5.4); and of high LDL cholesterol, 1.6 (95% CI = 0.7 to 3.5). CONCLUSION: Lipid levels in subjects who used both atypical and typical medication and those who used only typical medication were high even in young age. As these persons are at special risk of hyperlipidemia, their lipid levels should be regularly monitored, and a cholesterol-lowering diet, as well as medication, should be considered. The results indicate an elevated risk of hyperlipidemia in persons using antipsychotic medication independent of the other risk factors assessed.
机译：背景：吩噻嗪被引入后不久，发现它们会升高血清甘油三酸酯和总胆固醇水平。在过去的十年中，越来越多的文献也记录了非典型抗精神病药的这种作用。先前有关抗精神病药性高脂血症的研究都是基于临床样本，大部分来自病例系列。我们在前瞻性的，以人群为基础的一般出生队列中研究了服用和未服用抗精神病药物的受试者的高脂血症患病率。方法：研究样本由未选择的北芬兰1966年出生队列的5654名成员组成，他们参加了1997-1998年31岁的临床检查。整夜禁食后取血样，测定血清总胆固醇，高密度脂蛋白（HDL）胆固醇，低密度脂蛋白（LDL）胆固醇和甘油三酸酯水平。使用问卷对健康习惯和其他高脂血症可能的相关因素进行了评估。根据抗精神病药物的使用情况将样本分为4类：（1）非典型药物;（2）典型药物;（3）非典型药物和典型药物（对于3种抗精神病药物类别，总N = 45）;以及（4）无抗精神病药物（N ＝ 5609）。非参数测试和多元逻辑回归分析用于衡量抗精神病药对血脂的影响。结果：在非典型药物和典型药物治疗的患者中均发现高血脂水平（平均总胆固醇= 233 mg / dL，平均甘油三酸酯= 163 mg / dL）。仅使用常规药物的受试者的平均总胆固醇和甘油三酸酯也很高（分别为215 mg / dL和148 mg / dL）。与未使用抗精神病药物的人相比，使用抗精神病药物的人的高胆固醇血症，高LDL胆固醇和高甘油三酯血症的患病率较高（分别为12.2％，10.2％和7.0％） ）。在我们调整了高脂血症的危险因素（性别，饮食，腰围，体育锻炼，吸烟和饮酒）后，逻辑回归分析的结果显示，在接受抗精神病药物治疗的人中，高胆固醇血症的风险为2.8（95％CI = 1.4至5.6）;高甘油三酯血症，2.3（95％CI = 1.0至5.4）;高LDL胆固醇为1.6（95％CI = 0.7至3.5）。结论：使用非典型药物和典型药物的受试者和仅使用典型药物的受试者的脂质水平即使在年轻时也很高。由于这些人有高脂血症的特殊危险，应定期监测其血脂水平，并应考虑降低胆固醇的饮食以及药物治疗。结果表明，使用抗精神病药物的人与其他评估的危险因素无关，高脂血症的风险升高。

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