Şizofreni tanılı hastalarda metabolik sendrom ve D vitamini düzeyleri ilişkisi

Amaç: Bu çalışmada şizofreni tanılı hastalarda D vitamini, Pozitif ve Negatif Sendrom Ölçeği skorları, antipsikotik kullanımı ve sosyodemografik verilerin metabolik sendrom ile ilişkisinin gösterilmesi amaçlanmıştır.Gereç ve Yöntem: Retrospektif dosya tarama esasına bağlı bu çalışmaya Çukurova Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı yataklı servisinde sağaltım görmüş 31’inde metabolik sendrom tanısı olan 119 şizofreni tanılı hasta dahil edilmiştir. Hastaların sosyodemografik verileri, hastalık yılı, yatış sayısı, Pozitif ve Negatif Sendrom Ölçeği skorları, vitamin D kan düzeyleri, HDL, trigliserit, glukoz, HBa1c, arteriyel kan basıncı değerleri, bel çevresi, vücut kitle indeksi ölçümleri incelenmiştir. Bulgular: Çalışmaya dahil edilen hastaların 63’ü kadın, 56’sı erkektir. Hastaların 63’ünde vitamin D düzeyi düşüklüğü saptanmıştır. MS tanısı olanlar ve olmayanları arasında HDL, arteriyel kan basıncı, açlık kan glukozu, trigliserit, bel çevresi, vücut kitle indeksi değerlerinin analizinde anlamlı farklılık saptanmıştır. Bu değerler National Cholesterol Education Programme Adult Treatment Panel III metabolik sendrom tanı kriterleri olduğu için lojistik regresyon analizine dahil edilmemiştir. Basit lineer regresyon ve lojistik regresyon analizi ile metabolik sendrom tanısı olan grupta olmayanlara göre hastalık yılı ve hasta yaşları anlamlı olarak yüksek, D vitamini düzeyleri anlamlı olarak düşük saptanmıştır.Sonuç: Bu çalışmada metabolik sendrom riskini arttıran faktörlerden değiştirilebilir olan vitamin D kan düzeyine dikkat edilmesi gerektiği gösterilmiştir.

Anahtar Kelimeler:

Metabolik sendrom, D vitamini, psikotik bozukluk, şizofreni, antipsikotik

The relationship between metabolic syndrome and vitamin D levels in patients with schizophrenia

Purpose: The aim of this study was to determine the relationship between vitamin D levels, Positive and Negative Syndrome Scale scores, the use of antipsychotics and sociodemographic data in metabolic syndrome in patients with schizophrenia.Materials and Methods: A total of 119 patients with schizophrenia who were treated at inpatients clinics of Çukurova University Faculty of Medicine Department of Psychiatry were included in this retrospective study. Thirtyone of 119 patients with schizophrenia were diagnosed with metabolic syndrome. Sociodemographic data, duration of disorder, number of hospitalizations, Positive and Negative Syndrome Scale scores, vitamin D blood levels, HDL, triglyceride, glucose, HBa1c, arterial blood pressure, waist circumference, body mass index were measured.. Results: Of the patients included in the study, 63 were female and 56 were male. Vitamin D levels were lower in 63 patients. Significant differences were found in HDL, arterial blood pressure, fasting blood glucose, triglyceride, waist circumference, body mass index values among those with and without metabolic syndrome. These values are not included in the logistic regression analysis because they are metabolic syndrome diagnostic criteria for the National Cholesterol Education Program Adult Treatment Panel III. Simple linear regression and logistic regression analysis showed that the disease year and patient ages were significantly higher and vitamin D levels were significantly lower in the metabolic syndrome group. Conclusion: It has been shown that vitamin D blood level should be taken into account in the factors that increase the risk of metabolic syndrome..

Keywords:

Metabolic syndrome, vitamin D, psychotic disorder, schizophrenia, antipsychotic,

PDF

___

1. Karakuş G, Tamam L, Zengin M. Şizofreni hastalarında antipsikotik kullanımına bağlı hiperprolaktinemi ve kemik metabolizma bozuklukları. Anadolu Psikiyatri Derg. 2009;10:336- 42.
2. Hert, MD, Schreurs V, Vancampfort D, Winkel RV. Metabolic syndrome in people with schizophrenia: a review. World Psychiatry. 2009;8:15-22.
3. Songur E, Karslıoğlu EH, Soygür H, Kaymak SU, Özalp E. Şizofreni ve şizoaffektif bozuklukta metabolik sendrom. Klinik Psikiyatri Dergisi. 2012;15:80-91.
4. Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988;37:1595-607.
5. Expert Panel on Detection, Evaluation, and Treatment of High BloodCholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486–97.
6. Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somervs VK et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49:403-14.
7. Ito MK. The metabolic syndrome: pathophysiology, clinical relevance, and use of niacin. Ann Pharmacother. 2004;38:277-85.
8. Wacker M, Holick MF. Vitamin D-effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5:111-48.
9. Özkan B, Döneray H. D vitamininin iskelet sistemi dışı etkileri. Çocuk Sağlığı Hast Dergisi. 2011;54:99- 119.
10. Wrzosek M, Łukaszkiewicz J, Wrzosek M, Jacubzyk A, Matsumoto H, Piatkiewicz P et al. Vitamin D and the central nervous system. Pharmacol Rep. 2013;65(2):271-8.
11. Schneider B, Weber B, Frensch A, Stein J, Fritz J. Vitamin D in schizophrenia, major depression and alcoholism. J Neural Transm. 2000;107:839-42.
12. Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care. 2005;28:1228-30.
13. Martini LA, Wood RJ. Vitamin D status and the metabolic syndrome. Nutr Rev. 2006;64:479-86.
14. Wright ORL, Hickman IJ, Petchey WG, Sullivan CM, Ong C, Rose FJ et al. The effect of 25-hydroxyvitamin D on insulin sensitivity in obesity: is it mediated via adiponectin? Can J Physiol Pharmacol. 2013;91:496- 501.
15. Matyar S, Dişel NR, Açıkalın A, Kutnu M, İnal T. Çukurova bölgesinde D vitamini düzeyleri. Cukurova Medical Journal. 2017;42:320-8.
16. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13:261-76.
17. Kostakoğlu E, Batur S, Tiryaki A, Göğüs A. Pozitif ve negatif sendrom ölçeğinin (PANSS) Türkçe uyarlamasının geçerlik ve güvenilirliği. Türk Psikoloji Dergisi. 1999;14:23-32.
18. Haddad P. Weight change with atypical antipsychotics in the treatment of schizophrenia. J Psychopharmacol. 2005;19:16-27.
19. Perez-Iglesias R, Crespo-Facorro B, Martinez-Garcia O, Ramirez-Bonilla ML, Alvarez-Jimenez M, PelayoTeran JM et al. Weight gain induced by haloperidol, risperidone and olanzapine after 1 year: findings of a randomized clinical trial in a drug-naive population. Schizophr Res. 2008;99:13-22.
20. Muench J, Hamer AM. Adverse effects of antipsychotic medications. Am Fam Physician. 2010;81:617-22.
21. Harvey PD, Strassing M. Predicting the severity of everyday functional disability in people with schizophrenia: cognitive deficits, functional capacity, symptoms, and health status. World Psychiatry. 2012;11:73-9.
22. Laursen TM, Munk-Olsen T, Vestergaard M. Life expectancy and cardiovascular mortality in persons with schizophrenia. Curr Opin Psychiatry. 2012;25:83-8.
23. Heiskanen T, Niskanen L, Lyytikäinen R, Saarinen PI, Hintikka J. Metabolic syndrome in patients with schizophrenia. J Clin Psychiatry. 2003;64:575-9.
24. Abou Kassm S, Hoertel N, Naja W, McMahon K, Barriere S, Blumenstock Y et al. Metabolic syndrome among older adults with schizophrenia spectrum disorder: Prevalence and associated factors in a multicenter study. Psychiatry Res. 2019;275:238-46.
25. Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry. 2015;14:119-36.
26. De Hert M, Schreurs V, Sweers K, Van Eyck D, Hanssens L, Sinko S et al. Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in firstepisode patients with schizophrenia: A retrospective chart review. Schizophr Res. 2008;101:295-303.
27. Mitchell AJ, Vancampfort D, De Herdt A, Yu W, De Hert M. Is the prevalence of metabolic syndrome and metabolic abnormalities increased in early schizophrenia? A comparative meta-analysis of first episode, untreated and treated patients. Schizophr Bull. 2013;39:295-305.
28. Correll CU, Frederickson AM, Kane JM, Manu P. Does antipsychotic polypharmacy increase the risk for metabolic syndrome? Schizophr Res. 2007;89:91-100.
29. Çobanoğlu ZSÜ, Aker T, Çobanoğlu N. Şizofreni ve diğer psikotik bozukluğu olan hastalarda tedaviye uyum sorunları. Dusunen Adam. 2003;16:211-8.
30. Mitchell AJ, Vancampfort D, Sweers K, van Winkel R, Yu W, De Hert M. Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders-a systematic review and meta-analysis. Schizophr Bull. 2013;39:306-18.
31. McEvoy JP, Meyer JM, Goff DC, Nasrallah HA, Davis SM, Sullivan L et al. Prevalence of the metabolic syndrome in patients with schizophrenia: Baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res. 2005;80:19-32.
32. Cândido F, Bressan J. Vitamin D: Link between osteoporosis, obesity, and diabetes? Int J Mol Sci. 2014;15:6569-91.
33. Boucher BJ. Inadequate vitamin D status: does it contribute to the disorders comprising syndrome “X”? Br J Nutr. 1998;79:315-27.