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Yıl:2007; Cilt: 17; Sayı: 3>> Özet
TAM METİN
Klinik Psikofarmakoloji Bülteni; 2007;17(3):111-118
Atipik antipsikotik kullanan hastalarda ailede diyabet öyküsü olmasının glukoz metabolizması üzerine olan etkisi
F Yurtsever, AE Danacı, F Taneli, Ö Günay, B Veznedaroğlu
Celal Bayar Üniversitesi Tıp Fak. Psikiyatri ABD, Manisa
Amaç: Şizofreni hastalarında diyabet normal populasyona göre 2-3
kat daha fazla görülür. Son yıllarda atipik antipsikotiklere bağlı ortaya
çıkan diyabetten de pek çok yayında söz edilmiştir. Yaş, etnik köken,
şişmanlık, şişmanlık süresi, fiziksel aktivite ve ailede diyabet öyküsününün
bulunması gibi risk faktörleri diyabete yakalanmayı kolaylaştı-
rır. Bu çalışmanın amacı atipik antipsikotik kullanan hastalarda, diyabet
için bir risk faktörü olan, ailede diyabet öyküsü varlığının glukoz
metabolizmasını nasıl etkilediğini araştırmaktır.
Yöntem: Çalışmaya şizofreni veya başka bir psikotik bozukluk tanısı
almış ve en az 1 yıldır atipik antipsikotik kullanmakta olan toplam 70
hasta alınmıştır. Hastalar ailesinde diyabet öyküsü olan ve olmayan
diye iki gruba ayrılmıştır. Glukoz metabolizmasını değerlendirmek için
açlık kan şekeri, oral glukoz tolerans testi, kan insülin, c-peptit, hemoglobin
A1c, leptin ve ghrelin düzeylerine bakılmıştır.
Bulgular: Ailesinde diyabet öyküsü olan ve olmayan iki hasta grubunun
açlık kan şekeri, oral glukoz tolerans testi, kan insülin,c-peptit, hemoglobin
A1c, leptin ve ghrelin düzeylerinin karşılaştırılması sonucu
sadece ghrelin düzeyi ailesinde diyabet olan grupta daha yüksek bulunmuştur;
diğer parametreler açısından iki grup arasında istatistiksel
olarak anlamlı bir fark saptanmamıştır.
Sonuç: Atipik antipsikotik kullanan hastalarda ailede diyabet öyküsü
bulunması glukoz metabolizmasının bozulma olasılığını artırabilir. Tedaviye
başlamadan önce risk faktörlerini gözden geçirmek ve klinik
izlemde metabolik yan etkileri değerlendirmek amacıyla gerekli değerlendirmeleri yapmak akıllıca olacaktır.
The effect of the family history of diabetes on glucose metabolism of the patients receiving atypical antipsychotics
Objective: Diabetes is observed 2-3 times more frequently in
schizophrenic patients with comparison to the general population.
Recently, many publications have reported diabetes related to
atypical antipsychotics. Risk factors such as age, ethnicity, overweight,
duration of obesity, physical activity, and family history of diabetes
seem to help development of diabetes. This study aims to investigate
how the glucose metabolism is affected from familial history of
diabetes which is a risk factor for the disease.
Method: Seventy patients who have a diagnosis of schizophrenia or
other psychotic disorders and are treated with atypical antipsychotics
for at least one [year] were recruited for the study. The patients were
divided into two groups defined as those with or without a family
history of diabetes. In order to evaluate the glucose metabolism
fasting blood glucose, oral glucose tolerance, blood insuline, cpeptide,
hemoglobine A1c, leptin and ghrelin levels were measured.
Results: The results of the comparison of fasting blood glucose, oral
glucose tolerance, blood insuline, c-peptide, hemoglobine A1c, leptin
and ghrelin levels between two patient groups with and without
family history of diabetesonly ghrelin levels were found to be
statistically higher in the group of patients with a history of diabetes in
their family; no other parameters have statistically significant
differencesbetween two groups.
Conclusion: Having a family history of diabetes may increase the
probabality of disturbance in glucose metabolism of the patients
receiving atypical antipsychotics. It would be reasonable to evaluate the
risk factors prior to the treatment and routinely review the parameters
required to evaluate the metabolic side effects in clinical follow-ups.

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