Investigation and relationship analysis of glucolipid metabolism and insulin resistance in patients with first-episode non-medicated schizophrenia
10.3760/cma.j.cn115455-20200916-01251
- VernacularTitle:首发未服药精神分裂症患者糖脂代谢、胰岛素抵抗情况调查及关系分析
- Author:
Lina WANG
;
Xiujuan SONG
;
Chenghao DAI
- From:
Chinese Journal of Postgraduates of Medicine
2021;44(5):444-451
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the status of glucolipid metabolism and insulin resistance in patients with first-episode non-medicated schizophrenia, and to explore their relationship with psychiatric symptoms and cognitive function.Methods:One hundred and seventeen patients with first-episode non-medicated schizophrenia admitted to Wenzhou Seventh People′s Hospital from January 2018 to August 2020 were included in case group, and 61 healthy subjects with physical examination during the same period were used as control group. The glucose metabolism, including serum fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG), fasting insulin (FINS), fasting C peptide; lipid metabolism, including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C); apolipoprotein A1 (Apo-A1) and homeostatic model assessment insulin resistance index (HOMA-IR) level were compared between 2 groups. The abnormal glucolipid metabolism and incidence rate of insulin resistance were counted in the two groups. According to the condition of abnormal glucolipid metabolism or insulin resistance in case group, the patients were divided into abnormal glucolipid metabolism group and non-abnormal group, and insulin resistance group and non-insulin resistance group. The psychiatric symptoms (positive and negative symptom scale, PANSS) and cognitive function (MATRICS consensus cognitive battery, MCCB) were compared between 2 groups. Pearson correlation analysis was used to explore the correlation between glucolipid metabolism and insulin resistance and psychiatric symptoms and cognitive function in case group.Results:The levels of glucolipid metabolism indexes of 2 h PBG, FINS, fasting C peptide, TG and HOMA-IR in case group were significantly higher than those in control group: (7.06 ± 1.88) mmol/L vs. (6.19 ± 1.53) mmol/L, (8.61 ± 2.46) mU/L vs. (6.25 ± 1.71) mU/L, (0.49 ± 0.16) nmol/L vs. (0.32 ± 0.09) nmol/L, (1.33 ± 0.47) mmol/L vs. (1.02 ± 0.24) mmol/L, 2.01 ± 0.71 vs. 1.51 ± 0.45 ( P<0.05); while the levels of HDL-C and Apo-A1 were significantly lower than those in control group: (1.19 ± 0.38) mmol/L vs. (1.57 ± 0.32) mmol/L, (1.21 ± 0.25) g/L vs. (1.43 ± 0.17) g/L ( P<0.05). The total incidence rate of abnormal glucolipid metabolism or insulin resistance in case group was significantly higher than that in control group: 62.39%(73/117) vs. 13.11%(8/61) ( P<0.05). The scores of dimensions of positive symptoms, negative symptoms and general psychopathology and total score of PANSS in combined group were significantly higher than those in non-abnormal group: (25.14 ± 5.09) scores vs. (22.95 ± 4.72) scores, (24.68 ± 5.25) scores vs. (22.05 ± 4.59) scores, (41.52 ± 5.85) scores vs. (38.12 ± 4.18) scores, (94.68 ± 11.64) scores vs. (85.43 ± 8.51) scores ( P<0.05). The above scores points in insulin resistance group were higher than points in non-insulin resistance group: (26.62 ± 4.18) scores vs. (23.62 ± 4.98) scores, (25.92 ± 5.07) scores vs. (23.02 ± 4.96) scores, (42.94 ± 5.26) scores vs. (39.43 ± 4.47) scores, (97.35 ± 10.07) scores vs. (89.37 ± 10.25) scores ( P<0.05). The scores of continuous performance test-identical pairs (CPT-IP), working memory (WM), brief visuospatial memory test-revised (BVMT-R) and Mayer-Salovey-Caruso emotional intelligence test (MSCEIT) of MCCB scale in abnormal glucolipid metabolism group were significantly lower than those in non-abnormal group: (23.82 ± 5.21) scores vs. (27.15 ± 4.69) scores, (21.72 ± 5.95) scores vs. (25.35 ± 5.14) scores, (19.56 ± 5.28) scores vs. (22.34 ± 5.43) scores, (22.62 ± 5.13) scores vs. (26.47 ± 4.96) scores ( P<0.05), and the scores in insulin resistance group were significantly lower: (22.26 ± 4.84) scores vs. (25.42 ± 5.12) scores, (20.35 ± 4.87) scores vs. (23.46 ± 5.08) scores, (18.05 ± 4.27) scores vs. (20.98 ± 5.71) scores, (21.15 ± 4.67) scores vs. (24.48 ± 5.02) scores ( P<0.05). Pearson correlation analysis showed that 2 h PBG in case group was positively correlated with PANSS positive symptoms ( P<0.05), and was negatively correlated with CPT-IP and MSCEIT in MCCB scale ( P<0.05). FINS and HOMA-IR were positively correlated with positive symptoms, negative symptoms and PANSS total score ( P<0.05), and were negatively correlated with CPT-IP, WM, BVMT-R and MSCEIT ( P<0.05). HDL-C was negatively correlated with positive symptoms ( P<0.05), and was positively correlated with CPT-IP, WM and MSCEIT ( P<0.05). Apo-A1 was negatively correlated with positive symptoms and negative symptoms ( P<0.05), and was positively correlated with CPT-IP and WM ( P<0.05). Conclusions:Abnormal glucolipid metabolism and insulin resistance have a higher detection rate in first-episode non-medicated schizophrenia, and have a certain relationship with the psychiatric symptoms and cognitive impairment of patients.
