정신분열병 환자에서 항정신병 약물과 공복혈당 및 총 콜레스테롤 이상 = Antipsychotics and the Abnormality of Fasting Glucose, Total Cholesterol in Schizophrenia

다국어 초록 (Multilingual Abstract)

Objective :The concerns about significant weight gain induced by antipsychotics have been recently increased. It raised an issue about the possible effect of antipsychotics on the glucose and lipid metabolism. To address this issue, we investigated the prevalence of abnormal glucose metabolism(impaired fasting glucose (110mg/dl≤fasting glucose≤125mg/dl) or diabetes (fasting glucose≥126mg/dl)) in patients taking antipsychotics and also compared the prevalence of abnormal glucose metabolism between typical and atypical antipsychotics.
Methods:The subjects included 76 outpatients and 109 inpatients with schizophrenia by DSM-IV diagnostic criteria who had been taking antipsychotics regularly for at least 1 month. We measured fasting glucose, total cholesterol level after midnight NPO. Information about demographic and clinical characteristics of patients was gathered from interview with patients, family members, and the medical records.
Results :24 of 185 schizophrenia patients (13.0%) showed abnormal glucose metabolism. 6 of 47 patients taking olanzapine (12.8%) and 2 of 34 patients taking haloperidol (5.9%) showed abnormal glucose metabolism. The prevalence of abnormal glucose metabolism was higher with olanzapine than with haloperidol, although the difference did not reach statistical significance. However, patients with olanzapine showed higher fasting glucose level than those with haloperidol. There was no significant correlation between medication dose and fasting glucose, total cholesterol level.
Conclusion :The prevalence of abnormal glucose metabolism was higher in patients with antipsychotics. Olanzapine was more likely to raise fasting blood glucose to higher level than haloperidol.

국문 초록 (Abstract)

목 적：항정신병 약물에 의한 체중의 증가는 항정신병 약물이 당, 지질 대사에 영향을 줄 가능성이 있다는 것을 시사한다. 본 연구의 목적은 항정신병 약물이 당, 지질 대사에 미치는 영향을 알아보기 위한 것으로 항정신병 약물을 복용하고 있는 정신분열병 환자의 당대사 이상(공복혈당장애(110 mg/dl≤공복혈당≤125 mg/dl) 또는 당뇨병(공복혈당≥126 mg/dl)의 유병율을 조사하고 항정신병 약물 종류간에 유병율에 차이가 있는지 조사하였다. 방 법：항정신병 약물을 적어도 1개월 이상 꾸준히 복용한, DSM-Ⅳ 진단기준에 의해 정신분열병으로 진단받은 입원환자 109명, 외래 환자 76명을 대상으로 하였다. 전날 자정부터 금식한 환자의 공복혈당 및 총 콜레스테롤을 측정하였다. 환자에 대한 기본정보는 환자와의 직접 면담, 보호자와의 면담, 의무기록을 통해 얻었다. 결 과：정신분열병 환자 185명 중 24명(13.0%)이 당대사 이상을 보였다. 당대사 이상의 유병율이 약물간에 차이가 있는지 비교해 보면 olanzapine 복용 환자의 경우 47명 중 6명(12.8%), haloperidol 복용 환자의 경우 34명 중 2명(5.9%)에서 당대사 이상을 보였다. Ola -nzapine 복용한 군이 haloperidol 복용한 군보다 당대사 이상의 유병율은 높았지만 통계적으로 유의하지는 않았다. 그러나 공복혈당을 비교했을 때 olanzapine을 복용하고 있는 환자가 haloperidol을 복용하고 있는 환자보다 공복혈당이 유의미하게 높았다. 항정신병 약물의 용량과 공복혈당, 총 콜레스테롤 양과의 상관관계는 나타나지 않았다.결 론：항정신병 약물을 복용한 정신분열병 환자의 당대사 이상의 유병율은 13.0%였다. 그리고 olanzapine을 복용한 환자군이 haloperidol을 복용한 환자군 보다 공복혈당, 신체비만지수가 유의하게 높았고 총 콜레스테롤은 두 군간의 유의한 차이가 없었다.

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