精神分裂症或双相情感障碍患者服用第二代抗精神病药物后糖化血红蛋白和体重指数的阈下变化:日本一项全国前瞻性队列研究

Ryo Sawagashira, R. Yamamura, R. Okubo, N. Hashimoto, Shuhei Ishikawa, Yoichi Ito, Norihiro Sato, I. Kusumi
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引用次数: 3

摘要

目的:据报道,第二代抗精神病药物(SGAs)发生糖尿病的风险存在差异。然而,很少有研究关注糖化血红蛋白(HbA1c)的阈下变化。因此,本研究检测了在日本广泛开处方的6种SGAs中,患者服用其中一种后3个月HbA1c的阈下变化和体重指数(BMI)的变化。方法:这是一项基于日本精神分裂症患者血糖监测指南的前瞻性队列研究。在2013年4月至2015年3月期间,我们收集了符合条件的患者在基线和招募后3个月的人口统计数据、用药史、血液检查和体重测量数据。在基于ICD-10的378例精神分裂症、分裂情感性障碍和双相情感障碍患者中,我们采用多变量回归分析比较了抗精神病药物开始3个月后HbA1c的阈下变化和BMI的变化。结果:与奥氮平相比,布兰色林治疗3个月后HbA1c阈下变化显著降低(B = -0.17, 95% CI = -0.31 ~ -0.04)。此外,与奥氮平相比,布兰色林和阿立哌唑开始治疗3个月后BMI的变化显著降低(B = -0.93, 95% CI = -1.74 ~ -0.12;B = -0.71, 95% CI = -1.30至-0.12,分别)。结论:这是第一个阐明SGAs患者HbA1c阈下变化差异的研究。我们的研究结果表明,blonanserin可能是一种治疗糖尿病高危患者的有利药物。临床试验注册号:UMIN临床试验注册号:UMIN000009868。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Subthreshold Change in Glycated Hemoglobin and Body Mass Index After the Initiation of Second-Generation Antipsychotics Among Patients With Schizophrenia or Bipolar Disorder: A Nationwide Prospective Cohort Study in Japan.
Objective: The risk of diabetes development has been reported to differ among second-generation antipsychotics (SGAs). However, few studies have focused on the subthreshold change in glycated hemoglobin (HbA1c). Therefore, this study examined the subthreshold change in HbA1c and change in body mass index (BMI) 3 months after patients initiated one of 6 SGAs widely prescribed in Japan. Methods: This is a prospective cohort study of patients followed up based on the Japanese blood glucose monitoring guidelines for patients with schizophrenia. We collected eligible patients' demographic data, medication history, blood tests, and weight measurements both at baseline and 3 months after recruitment, between April 2013 and March 2015. In the 378 patients with schizophrenia, schizoaffective disorder, and bipolar disorder based on ICD-10, we compared the subthreshold change in HbA1c and the change in BMI 3 months after antipsychotic initiation by using multivariate regression analysis. Results: The subthreshold change in HbA1c 3 months after initiating blonanserin was significantly lower compared with olanzapine (B = -0.17, 95% CI = -0.31 to -0.04). In addition, the change in BMI 3 months after initiating blonanserin and aripiprazole was significantly lower compared with olanzapine (B = -0.93, 95% CI = -1.74 to -0.12; B = -0.71, 95% CI = -1.30 to -0.12, respectively). Conclusions: This is the first study to clarify the differences in the subthreshold change in HbA1c among SGAs. Our results suggest that blonanserin is likely to be a favorable treatment for patients with high risk of diabetes. Trial Registration: UMIN Clinical Trial Registry identifier: UMIN000009868.
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