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精神分裂症患者的代谢综合征:潜在机制与治疗方法(综述)

Metabolic syndrome in patients with schizophrenia: Underlying mechanisms and therapeutic approaches (Review).

作者信息

Manta Aspasia, Georganta Anastasia, Roumpou Afroditi, Zoumpourlis Vassilis, Spandidos Demetrios A, Rizos Emmanouil, Peppa Melpomeni

机构信息

Endocrine Unit, Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece.

Third Department of Internal Medicine, Sotiria General Hospital for Chest Diseases, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.

出版信息

Mol Med Rep. 2025 May;31(5). doi: 10.3892/mmr.2025.13479. Epub 2025 Feb 28.

Abstract

Schizophrenia (SCZ) represents a considerable health concern, not only due to its impact on cognitive and psychiatric domains, but also because of its association with metabolic abnormalities. Individuals with SCZ face an increased risk of developing metabolic syndrome (MS), which contributes to the increased cardiovascular burden and reduced life expectancy observed in this population. Metabolic alterations are associated with both the SCZ condition itself and extrinsic factors, particularly the use of antipsychotic medications. Additionally, the link between SCZ and MS seems to be guided by distinct genetic parameters. The present narrative review summarizes the relationship between SCZ and MS and emphasizes the various therapeutic approaches for managing its components in patients with these conditions. Recommended therapeutic approaches include lifestyle modifications as the primary strategy, with a focus on behavioral lifestyle programs, addressing dietary patterns and physical activity. Pharmacological interventions include administering common antidiabetic medications and the selection of less metabolically harmful antipsychotics. Alternative interventions with limited clinical application are also discussed. Ultimately, a personalized therapeutic approach encompassing both the psychological and metabolic aspects is essential for the effective management of MS in patients with SCZ.

摘要

精神分裂症(SCZ)是一个重大的健康问题,不仅因其对认知和精神领域的影响,还因其与代谢异常有关。SCZ患者患代谢综合征(MS)的风险增加,这导致该人群心血管负担加重和预期寿命缩短。代谢改变与SCZ病情本身以及外在因素有关,特别是抗精神病药物的使用。此外,SCZ与MS之间的联系似乎受不同基因参数的指导。本叙述性综述总结了SCZ与MS之间的关系,并强调了在患有这些疾病的患者中管理其组成部分的各种治疗方法。推荐的治疗方法包括将生活方式改变作为主要策略,重点是行为生活方式项目,解决饮食模式和身体活动问题。药物干预包括使用常见的抗糖尿病药物以及选择代谢危害较小的抗精神病药物。还讨论了临床应用有限的替代干预措施。最终,一种涵盖心理和代谢方面的个性化治疗方法对于有效管理SCZ患者的MS至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9107/11894597/8d46e934ced0/mmr-31-05-13479-g00.jpg

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