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The Korean Journal of Medicine 2008;75(6): 673-679.
정신분열병 환자의 인슐린저항성 결정인자
김철식, 조민호, 남지선, 박종숙, 남윤영, 김찬형, 안철우, 김경래
A determinant of insulin resistance in patients with schizophrenia
Chul Sik Kim, Min Ho Cho, Ji Sun Nam, Jong Suk Park, Yoon Young Nam, Chan Hyung Kim, Chul Woo Ahn, Kyung Rae Kim
인제 의대 부산 백병원 호흡기 내과
As compared with the general population, patients with schizophrenia have a higher risk of obesity and glucose metabolism impairment. Moreover, some antipsychotic drugs add to this risk owing to side effects such as weight gain. However, few reports exist regarding the pathophysiology of insulin resistance in drug-naïve or drug-free schizophrenic patients. Therefore, the aim of the present study was to investigate the factors that contribute to insulin resistance in antipsychotic drug-naïve and drug-free schizophrenic patients.
Nineteen (4 men, 15 women) drug-naïve or drug-free subjects with schizophrenia and nineteen age- and sex-matched controls were recruited for participation in this study. We measured weight, height, waist circumference, biochemical profiles, body fat percentage, and calculated body mass indices (BMI) in all patients. Furthermore, we correlated HOMA-IR, a marker for insulin resistance, with anthropometric measures and clinical characteristics.
There were no significant differences in BMI, waist circumference, or body fat percentage between the two groups. In addition, there were no differences in blood pressure, glucose, HbA1c, insulin, HOMA-IR, total cholesterol, HDL-cholesterol, or LDL-cholesterol; however, triglyceride levels and 24 hr urine free cortisol levels were higher in schizophrenic patients. There was also a significant correlation between HOMA-IR and both age and waist circumference in the control group. Additionally, HOMA-IR was significantly correlated with 24 hr urine free cortisol levels in schizophrenic patients.
The study shows that risk factors for insulin resistance in drug-naïve or drug-free schizophrenic patients do not differ from those of the control group; however, the major determinant of insulin resistance in schizophrenia patients was that of increased cortisol levels. (Korean J Med 75:673-679, 2008)
Keywords: Schizophrenia; Diabetes Mellitus; Insulin Resistance
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