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首页> 外文期刊>The journal of clinical psychiatry >Major changes in glucose metabolism, including new-onset diabetes, within 3 months after initiation of or switch to atypical antipsychotic medication in patients with schizophrenia and schizoaffective disorder.
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Major changes in glucose metabolism, including new-onset diabetes, within 3 months after initiation of or switch to atypical antipsychotic medication in patients with schizophrenia and schizoaffective disorder.

机译：精神分裂症和精神分裂症患者开始或改用非典型抗精神病药物后3个月内，葡萄糖代谢的主要变化，包括新发糖尿病。

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OBJECTIVE: To investigate 3-month changes in glucose metabolism in a naturalistic sample of patients with schizophrenia newly started on or switched to specific atypical antipsychotic medication therapy. METHOD: One hundred eighty-three patients were evaluated before initiation and 3 months after with a 75-g glucose load oral glucose tolerance test (OGTT). Data were collected between November 2003 and January 2007. RESULTS: Eight patients (4.4%) developed new-onset diabetes within 3 months. Initiation of clozapine resulted in a significantly higher risk for new-onset glucose abnormalities than initiation of aripiprazole (odds ratio = 67.29, 95% CI = 5.23 to 866.49). Significant drug x time interactions were found for all OGTT glucose assessments (fasting: F = 6.79, df = 5,177; p < .0001; 30 minutes: F = 3.89, df = 5,177; p = .0023; 60 minutes: F = 5.03, df = 5,177; p = .0002; 120 minutes: F = 3.78, df = 5,177; p = .0028), with the evolution of plasma glucose levels being significantly worse in patientsinitiated on clozapine therapy (fasting, 30 minutes, and 60 minutes), olanzapine therapy (fasting, 60 minutes, and 120 minutes), and quetiapine therapy (fasting and 60 minutes) than in patients initiated on aripiprazole therapy (p < .05). Clozapine was also significantly more deleterious than risperidone and amisulpride for fasting plasma glucose level changes (p < .05). Type of initiation (start or switch) did not affect any of the metabolic parameters. CONCLUSIONS: The incidence of new-onset glucose abnormalities, including diabetes, in the first 3 months after newly starting or switching atypical antipsychotic medication is high and may be markedly influenced by type of prescribed antipsychotic. The importance of accurately screening for new-onset glucose abnormalities after initiation of an atypical antipsychotic is emphasized.
机译：目的：调查新开始或转为特定的非典型抗精神病药物治疗的精神分裂症患者自然样本中葡萄糖代谢的3个月变化。方法：183例患者在开始前和术后3个月接受了75 g葡萄糖负荷口服葡萄糖耐量试验（OGTT）的评估。在2003年11月至2007年1月之间收集了数据。结果：8例（4.4％）在3个月内患上了新发糖尿病。氯氮平的引发比阿立哌唑的引发导致新发葡萄糖异常的风险显着更高（优势比= 67.29，95％CI = 5.23至866.49）。在所有OGTT葡萄糖评估中均发现了显着的药物x时间相互作用（禁食：F = 6.79，df = 5,177; p <.0001; 30分钟：F = 3.89，df = 5,177; p = .0023; 60分钟：F = 5.03 ，df = 5,177; p = .0002; 120分钟：F = 3.78，df = 5,177; p = .0028），开始使用氯氮平治疗的患者血浆葡萄糖水平的演变显着恶化（禁食，30分钟和60分钟） 3分钟），奥氮平治疗（禁食，60分钟和120分钟）和喹硫平治疗（禁食和60分钟）比使用阿立哌唑治疗的患者（p <.05）高。与空腹血浆葡萄糖水平变化相比，氯氮平的毒性也明显高于利培酮和氨磺必利（p <.05）。启动类型（启动或切换）不影响任何代谢参数。结论：新开始或改用非典型抗精神病药物后的前三个月，新发葡萄糖异常（包括糖尿病）的发生率很高，可能受到处方抗精神病药物类型的显着影响。强调了非典型抗精神病药启动后准确筛查新发葡萄糖异常的重要性。

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