范誉,钟少玲,周亮,苏敬华,陈夕圆,黄霄敏.社区精神分裂症患者代谢综合征影响因素[J].四川精神卫生杂志,2023,36(6):515-520.Fan Yu,Zhong Shaoling,Zhou Liang,Su Jinghua,Chen Xiyuan,Huang Xiaomin,Influencing factors of metabolic syndrome in community patients with schizophrenia[J].SICHUAN MENTAL HEALTH,2023,36(6):515-520
社区精神分裂症患者代谢综合征影响因素
Influencing factors of metabolic syndrome in community patients with schizophrenia
投稿时间:2023-01-11  
DOI:10.11886/scjsws20230111003
中文关键词:  精神分裂症  代谢综合征  社区  健康体检  影响因素
英文关键词:Schizophrenia  Metabolic syndrome  Community  Health examination  Influencing factors
基金项目:广州市卫生健康科技项目(项目名称:广州市社区严重精神障碍患者代谢综合征患病率及其危险因素的流行病学调查,项目编号,20221A010028)
作者单位邮编
范誉 广州医科大学附属脑科医院广东 广州 510370 510370
钟少玲 广州医科大学附属脑科医院广东 广州 510370 510370
周亮 广州医科大学附属脑科医院广东 广州 510370 510370
苏敬华 广州医科大学附属脑科医院广东 广州 510370 510370
陈夕圆 广州医科大学附属脑科医院广东 广州 510370 510370
黄霄敏 广州医科大学附属脑科医院广东 广州 510370 510370
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中文摘要:
      背景 精神分裂症患者是罹患代谢综合征的高风险人群。既往关于代谢综合征影响因素的研究主要集中于住院精神分裂症患者,对社区精神分裂症患者的研究较少。目的 探索广州市社区精神分裂症患者不同代谢综合征风险层级的影响因素,为社区精神分裂症患者代谢综合征干预提供参考。方法 于2021年11月,选取广州市精神卫生信息系统在册在管且完成2020年度健康体检的精神分裂症患者3 339例。从信息系统导出患者健康体检资料,采用《中国2型糖尿病防治指南(2020年版)》评估患者是否罹患代谢综合征。根据《精神分裂症患者代谢综合征管理的中国专家共识》,将患者分为高风险组(n=423)、临界组(n=1 524)和代谢综合征组(n=1 392)。采用多元Logistic回归分析社区精神分裂症患者罹患代谢综合征的危险因素。结果 社区精神分裂症患者代谢综合征患病率为41.69%。单因素分析显示,三组在性别(χ2=44.610)、年龄(χ2=55.992)、婚姻状况(χ2=30.755)、病程(χ2=25.913)和体质量指数(χ2=829.265)方面差异均有统计学意义(P均<0.01)。Kruskal-Wallis H检验显示,三组患者腰围(H=920.331)、收缩压(H=436.673)、舒张压(H=393.337)、空腹血糖(H=807.304)、甘油三酯(H=1 134.125)、高密度脂蛋白胆固醇(H=593.615)水平差异均有统计学意义(P均<0.01)。Logistic回归分析显示,年龄≥50岁(OR=1.761,95% CI:1.087~2.853)、超重(OR=2.418,95% CI:1.862~3.140)和肥胖(OR=57.903,95% CI:14.340~233.802)是社区精神分裂症患者成为代谢综合征临界人群的危险因素(P<0.05或0.01);女性(OR=1.295,95% CI:1.034~1.622)、年龄40~49岁(OR=2.597,95% CI:1.582~4.263)、年龄≥50岁(OR=4.392,95% CI:2.609~7.395)、超重(OR=7.844,95% CI:6.018~10.223)和肥胖(OR=426.785,95% CI:105.724~1 722.839)是社区精神分裂症患者成为代谢综合征人群的危险因素(P<0.05或0.01)。结论 社区精神分裂症患者代谢综合征患病率较高,女性、年长、超重和肥胖是精神分裂症患者罹患代谢综合征的高风险因素。
英文摘要:
      Background Patients with schizophrenia are at high risk of suffering from metabolic syndrome. Most previous studies on the influencing factors of metabolic syndrome focused on the inpatients and limited ones on patients dwelling in community.Objective To explore the influencing factors at different risk levels of metabolic syndrome in community-dwelling patients with schizophrenia in Guangzhou, so as to provide references for future interventions on metabolic syndrome in this patient population.Methods In November 2021, 3 339 patients with schizophrenia who were registered in and administered by Guangzhou Mental Health Information System were included. All these patients had finished the physical examination in 2020, and whether they had metabolic syndrome was assessed basing on Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition). Patients were divided into high-risk group (n=423), critical group (n=1 524) and metabolic syndrome group (n=1 392) according to the Chinese expert consensus on the management of metabolic syndrome in patients with schizophrenia. Multiple logistic regression analysis were performed on the risk factors of metabolic syndrome in community-dwelling patients with schizophrenia.Results The prevalence rate of metabolic syndrome in community-dwelling patients with schizophrenia was 41.69%. Univariate analysis showed that the results in gender (χ2=44.610), age (χ2=55.992), marriage status (χ2=30.755), illness course (χ2=25.913) and body mass index (χ2=829.265) were significantly different among the three groups (P<0.01). Kruskal-Wallis H test showed that the levels of waist circumference (H=920.331), systolic blood pressure (H=436.673), diastolic blood pressure (H=393.337), fasting blood glucose (H=807.304), triglyceride (H=1 134.125) and high-density lipoprotein cholesterol (H=593.615) among the three groups were significantly different (P<0.01). Logistic regression analysis showed that age ≥50 (OR=1.761, 95% CI: 1.087~2.853), overweight (OR=2.418, 95% CI: 1.862~3.140) and obesity (OR=57.903, 95% CI: 14.340~233.802) were risk factors contributing to high-risk patients becoming critical population (P<0.05 or 0.01). Female gender (OR=1.295, 95% CI: 1.034~1.622), aged 40~49 (OR=2.597, 95% CI: 1.582~4.263), age ≥50 (OR=4.392, 95% CI: 2.609~7.395), overweight (OR=7.844, 95% CI: 6.018~10.223) and obesity (OR=426.785, 95% CI: 105.724~1 722.839) were risk factors for high-risk patients developing into metabolic syndrome population (P<0.05 or 0.01).Conclusion The prevalence rate of metabolic syndrome is higher in community-dwelling patients with schizophrenia. Female gender, older age, overweight and obesity would increase the risk of metabolic syndrome in schizophrenic patients. [Funded by Health Science and Technology Project in Guangzhou (number, 20221A010028)]
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