Objective To investigate the effect of second generation antipsychotics (SGAs) on adiponectin (APN) and metabolic indicators and to explore the role of APN in the antipsychotic-induced weight gain (AIWG). Methods A total of 86 drug na?ve first episode schizophrenia patients and 88 sex-and age-matched healthy controls were collected. All patients received a single SGAs treatment for 8 weeks. In patient group, the level of weight, body mass index (BMI), waist-to-hip ratio (WHR), fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), APN and fasting insulin (FINS) were measured before and after 8-week treatment. While as the control group was only measured once after enroll?ment. Results The serum APN [(9.32 ± 0.76) μg/mL vs. (10.9 ± 0.66) μg/mL] was lower and FINS was higher [(20.27 ± 15.02)μIU/mL vs. (12.68±11.70)μIU/mL] in drug na?ve patients compared with healthy controls (P<0.05). After 8-weekSGAs treatment, patients showed significant increases in weight [(59.01 ± 10.56) kg vs. (63.80 ± 9.78) kg], BMI [(21.74 ± 3.57) kg/m2 vs.(23.49±3.44) kg/m2], WHR [(0.88±0.07) vs. (0.92±0.05)], TG [(0.94±0.92) mmol/L vs. (1.63±1.08) mmol/L] and FINS [(12.68 ± 11.70)μIU/mL vs. (20.27 ± 15.02)μIU/mL], and significant decreases in APN [(9.32 ± 0.76)μg/mL vs. (8.03±0.68)μg/mL] and FPG [(5.04±1.01) mmol/L vs. (4.46±0.57) mmol/L] (all P<0.05). In male patients, baseline APN levels were positively correlated with AIWG (r=0.548,P=0.005). Conclusion The serum APN levels in drug na?ve first episode schizophrenic patients are significantly lower than normal and are further decreased after SGAs treatment. Base?line APN may predict the AIWG in male patients.%目的 通过检测首发精神分裂症患者(first-episode schizophrenic patients,FEP)服用第二代抗精神病药物(second generation antipsychotics,SGAs)8周前后的血清脂联素(adiponectin,APN)及代谢相关指标水平,探讨SGAs对首发精神分裂症患者APN的影响以及APN在SGAs引发肥胖中的作用.方法 选取86例首发未服药的精神分裂症患者,及88名性别年龄相匹配的正常对照,患者组使用单一SGAs治疗8周,测定患者组治疗前、治疗8周末及对照组的体重、体质指数(body mass index,BMI)、腰臀比(waist-to-hip ratio,WHR)及空腹血糖(fasting plasma glucose,FPG)、甘油三酯(triglyceride,TG)、APN、空腹胰岛素(fasting insulin,FINS)等指标.结果 患者组在治疗前APN水平低于对照组[(9.32±0.76)μg/mL vs.(10.9±0.66)μg/mL],FINS水平高于对照组[(12.68±11.70)μIU/mL vs.(6.47±2.87)μIU/mL],差异有统计学意义(P<0.05).与治疗前相比,患者组SGAs治疗8周后体重[(59.01±10.56)kg vs.(63.80±9.78)kg]、BMI[(21.74±3.57)kg/m2 vs.(23.49±3.44)kg/m2]、WHR[(0.88±0.07)vs.(0.92±0.05)]、TG[(0.94±0.92)mmol/L vs.(1.63±1.08)mmol/L]和FINS水平[(12.68±11.70)μIU/mL vs.(20.27±15.02)μIU/mL]增加,差异均有统计学意义(P<0.01),而患者组治疗后APN[(9.32±0.76)μg/mL vs.(8.03±0.68)μg/mL]及FPG[(5.04±1.01)mmol/L vs.(4.46±0.57)mmol/L]水平降低,差异均有统计学意义(P<0.05).在男性患者组中,基线APN水平与治疗后体重增加值呈正相关(r=0.548,P=0.005),女性患者组中该相关无统计学意义(P>0.05).结论 首发精神分裂症患者在治疗前APN水平降低,SGAs可进一步降低患者APN水平;在男性患者中,基线APN水平对服药后的体重增加有预测作用.
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