喀麦隆精神病患者和接受抗精神病药物治疗的糖尿病风险:一项横断面研究

Hermine Raissa Hell, Maxwell Nguedjo Wandji, Celine Sylvie Mimboe Bilongo, Ruth Edwige Dibacto Kemadjou, Boris Ronald Tchuente Tonou, Therese Henriette Dimodi, Gabriel Medoua Nama, O. Bassong
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引用次数: 0

摘要

背景:糖尿病是一个全球性的公共卫生问题,在撒哈拉以南的非洲国家,如喀麦隆。根据许多研究,使用抗精神病药物会使患有精神疾病的人患糖尿病的风险增加2到3倍,是普通人群的2到3倍。本研究旨在评估抗精神病药物对患糖尿病风险的影响,并确定精神病患者血糖水平异常的其他预测因素。方法:于2018年1月3日至19日进行横断面研究。在雅温得Jamot医院招募了年龄在18岁以上的精神病患者,在开始抗精神病治疗前未被诊断为糖尿病。使用问卷收集社会人口学、人体测量学和临床数据。采用卡方检验评估高血糖与分类变量之间的关系,采用多变量logistic回归模型通过社会科学统计软件包(SPSS) 20.0版本确定高血糖的独立预测因子。结果:共纳入82例患者(男41例,女41例)。非典型抗精神病药物组空腹血糖≥100mg /dL(124.74±23.31mg/dL)高于典型抗精神病药物组(115.74±18.63 mg/dL);高血糖与治疗时间呈正相关且不显著(r=0.215;p = 0.053)。然而,在典型和非典型抗精神病患者中,空腹血糖水平在110-125mg/dL之间,处于同一水平(分别为118.07±4.84 mg/dL和118.09±3.41mg/dL)。男性(OR=1.41;95% CI 0.54-3.64),年龄组< 35岁(OR=1.84;95% CI 0.69-4.88),单一(OR=2.18;95% CI 0.83-5.67),典型抗精神病药物(OR=1.12;95% CI 0.42-3.01),精神分裂症(OR=1.80;95% CI 0.25-12.84)和双相情感障碍(OR=1.50;95% CI 0.14-15.46)是这些患者高血糖的独立预测因子。结论:应对精神病患者和正在接受治疗的患者进行人体测量学和临床参数的定期监测。因此,他们应该受益于对糖尿病危险因素的良好管理,以预防疾病的发生,并避免这一弱势群体发病率和死亡率的增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of Diabetes in Cameroonian Patients with Psychosis and Under Antipsychotic Therapy: A Cross-Sectional Study
Background: Diabetes is a public health problem worldwide and in sub-Saharan African countries such as Cameroon. According to many studies, the use of antipsychotic drugs increases the risk of developing diabetes mellitus by 2 to 3 times more in people with psychotic disorders than in the general population. The present study aimed to assess the influence of antipsychotic drugs used on the risk of developing diabetes and to identify other factors predictive of abnormal blood glucose levels in patients suffering from psychosis. Methods: A cross-sectional study was conducted from the 3rd to the 19th of January 2018. Patients aged at least 18 years old suffering from psychosis and undiagnosed as diabetic before initiation of antipsychotic treatment were recruited at the Jamot Hospital in Yaounde. A questionnaire was used to collect sociodemographic, anthropometric, and clinical data. The Chi-Square test was used to assess the relationship between hyperglycemia and categorical variables and the multivariate logistic regression model was used to determine independent predictors of hyperglycemia through the Statistical Package for the Social Sciences (SPSS) version 20.0. Results: A total of 82 patients were included in the study (41 males and 41 females). The fasting blood sugar ≥100 mg/dL appeared to be higher but not significant in patients on atypical antipsychotic therapy (124.74±23.31mg/dL) compared to patients on typical antipsychotic therapy (115.74±18.63 mg/dL); with a positive and non-significant correlation between hyperglycemia and duration of treatment (r=0.215; p=0.053). However, in both typical and atypical antipsychotic patients, fasting glucose sugar levels between 110-125mg/dL were observed at the same level (118.07±4.84 mg/dL and 118.09±3.41mg/dL respectively). Male sex (OR=1.41; 95% CI 0.54-3.64), age group < 35 years (OR=1.84; 95% CI 0.69-4.88), single (OR=2.18; 95% CI 0.83-5.67), typical antipsychotic drugs (OR=1.12; 95% CI 0.42-3.01), schizophrenia (OR=1.80; 95% CI 0.25-12.84) and bipolar disorder (OR=1.50; 95% CI 0.14-15.46) were independent predictors of hyperglycemia in those patients. Conclusion: Regular monitoring of anthropometric and clinical parameters should be assigned to people suffering from psychotic disorders and under treatment. Therefore, they should benefit from good management of the risk factors for diabetes to prevent the onset of the disease and avoid increased morbidity and mortality in this vulnerable population.
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