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Yıl:2013; Cilt: 3; Sayı: 2>> Özet
Güncel Psikiyatri ve Psikonörofarmakoloji; 2013;3(2):13-20
Atipik Antipsikotik İlaç Kullanan Bir Grup Şizofreni Hastasında Metabolik Sendrom Sıklığı
A Demirel, ÖF Demirel, MT Kadak, M Uğur
Fatih Üniversitesi, İstanbul
hastalarında metabolik sendrom (MS) oranını ve MS bileşenlerini belirlemek, metabolik sendromun hastalığın bazı klinik özellikleriyle olası ilişkisi incelemekti. Ayrıca her iki grubun da tip 2 diyabete yatkınlığı olabileceği kanısıyla şizofreni hastaları ve onların kardeşleri glukoz metabolizması parametreleri yönünden karşılaştırıldı. Metot: Araştırma psikoz polikliniğinden takip edilen şizofreni hastaları (n=39), onların sağlıklı kardeşleri (n=39) ve kontrol grubu (n=39) üzerinde yürütüldü. İncelemelerde grupların tümüne sosyo-demografik veri formu, hastalara ve kardeşlerine DSM-IV Eksen I Bozuklukları İçin Yapılandırılmış Klinik Görüşme (SCID I) ve hastalara ayrıca Kısa Psikiyatrik Değerlendirme Ölçeği (BPRS) uygulandı. Metabolik sendrom oranını belirlemede ATP III-A (Erişkin Tedavi Paneli III-A), ölçütleri esas alındı. Bulgular: Çalışmada MS bakımından hasta (n=15; %38.4) ve kontrol grubunun (n=7; %17.9) dağılımları arasındaki fark anlamlıdır. Hastaların kilo, beden kitle indeksi, bel çevresi, insulin ve trigliserid ortalamalarının kontrollere göre önemli ölçüde yüksek olduğu belirlenmiştir. Ayrıca şizofreni hastaları kardeşleriyle boy, kilo, beden kitle indeksi, bel çevresi ve glukoz düzeyleri bakımından önemli ölçüde benzerlik göstermektedir. Şizofreni hastalarında yaş, cinsiyet, hastalığın başlama yaşı, ailede şizofreni öyküsü, intihar öyküsü ve saldırganlık özelliklerinin metabolik sendromun başlamasına etkisi olmadığı saptanmıştır. Tartışma: Bulgularımız AAP kullanan hastalarda metabolik sendromun sağlıklı popülasyona göre daha yüksek oranlarda görüldüğü görüşünü desteklemektedir. Hastaların kardeşleriyle antropometrik ölçümler ve glukoz düzeyleri bakımından anlamlı ölçüde benzerlik gösterdiği bulundu, fakat kardeşlerin metabolik özelliklerinin şizofreni hastalarında diyabet ve obezite gibi metabolik bozuklukların gelişmesinde belirleyici bir risk faktörü oluşturmadığı saptandı.
Metabolic Syndrome Prevalance in a Group of Patients with Schizophrenia Using Atypical Antipsychotic
Purpose: The aims of our study were to detect the MS parameters and prevalances of MS in healthy controls and in schizophrenia patients using AAP and examine the correlation of MS with some symptoms of the illness. Based on the idea is that both schizoprenia patients and their siblings are prone to type 2 diabetes, we compared parameters of glucose metabolism between these two groups. Method: Schizophrenia patients followed in our psychosis clinic (n=39), their healthy siblings (n=39), and controls (n=39), were included in the study. Socio-demografic data scale were given to all groups, Structured Clinical Interwiev for DSM-IV Axis I Disorders was applied to patients and their siblings, whereas Brief Psychiatric Rating Scale was applied only to the patients. Prevalances of the metabolic syndrome were determined based on ATP III-A (Adult Treatment Panel III-A) criteria. Findings: Distribution of patient and control group in terms of MS was found significant. When compared to controls, weight, body mass index, abdominal circumference, insulin and triglyceride mean values were found much more higher in patients. Schizophrenia patients had some significant similarities with their siblings in terms of serum glucose levels and antropometric mesurements. Age and sex of the patient, disease onset, family history, suicid and/or aggression history had no effect on the development of MS. Conclusions: Even though significant similarities found between patients and siblings in terms of glucose levels and antropometric measurements, metabolic states of siblings were not evaluated as a determining risk factor for the development of metabolic abnormalities as diabetes and obesity in patients with schizophrenia.

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