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首页> 外文期刊>The journal of clinical psychiatry >Antipsychotic medications: metabolic and cardiovascular risk.
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Antipsychotic medications: metabolic and cardiovascular risk.

机译：抗精神病药物：代谢和心血管风险。

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Individuals with serious mental illness experience excess morbidity and mortality, including an increased prevalence of diabetes mellitus and cardiovascular disease. Cardiovascular disease is the leading cause of death in persons with serious mental illness, and the elevated prevalence of obesity in this population is of particular concern. Obesity is an independent cardiometabolic risk factor that impacts morbidity and mortality and contributes to the development of other cardiometabolic risk factors, such as dyslipidemia and hypertension. In addition, obesity is a major risk factor for type 2 diabetes, with the relative risk of diabetes increasing with body mass index. Increased abdominal fat is strongly associated with insulin resistance, which can lead to impaired glucose regulation. Abdominal obesity, hyperglycemia, hypertension, and dyslipidemia are key components of the metabolic syndrome, a constellation of cardiometabolic risk factors linked by their common association with insulin resistance.Evidence from large clinical samples indicates a high prevalence of metabolic syndrome and all of its components in persons with serious mental illness, particularly in patients with schizophrenia. In addition, psychotropic agents, including some antipsychotic medications, are associated with substantial weight gain, as well as with adiposity-dependent and possibly adiposity-independent changes in insulin sensitivity and lipid metabolism, which increase the risk of diabetes and cardiovascular disease. Among the second-generation antipsychotics, clozapine and olanzapine are associated with the highest risk of substantial weight gain, similar to the weight gain potential associated with low-potency first-generation antipsychotics such as thioridazine or chlorpromazine, as well as with an increased risk of diabetes and dyslipidemia. Various strategies for monitoring cardiometabolic risk factors in patients with mental illness are discussed in this review.
机译：患有严重精神疾病的人会出现较高的发病率和死亡率，包括糖尿病和心血管疾病的患病率增加。心血管疾病是严重精神疾病患者的主要死亡原因，特别令人关注的是肥胖症在这一人群中的患病率升高。肥胖是一种独立的心脏代谢危险因素，它会影响发病率和死亡率，并导致其他心脏代谢危险因素的发展，例如血脂异常和高血压。此外，肥胖是2型糖尿病的主要危险因素，糖尿病的相对危险度随体重指数增加而增加。腹部脂肪增加与胰岛素抵抗密切相关，胰岛素抵抗可能导致葡萄糖调节受损。腹部肥胖，高血糖，高血压和血脂异常是代谢综合征的关键组成部分，这是一组与胰岛素抵抗相关的心脏代谢危险因素，来自大量临床样本的证据表明，代谢综合征及其所有成分的患病率很高。患有严重精神疾病的人，尤其是精神分裂症患者。另外，精神药物，包括一些抗精神病药物，与体重的大量增加有关，并且与胰岛素敏感性和脂质代谢的依赖于脂肪的和可能依赖于脂肪的变化有关，这增加了患糖尿病和心血管疾病的风险。在第二代抗精神病药中，氯氮平和奥氮平与体重增加的最高风险相关，类似于与低效第一代抗精神病药（如硫代哒嗪或氯丙嗪）相关的体重增加潜力，以及增加的糖尿病和血脂异常。这篇综述讨论了监测精神疾病患者心脏代谢危险因素的各种策略。

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