Canem KAVURMA, Halil KARA, ŞERMİN YALIN SAPMAZ, Deniz ÖZTÜRK KARA, ARİF ÖNDER

Duygudurum bozukluğu ve psikotik bozukluğu olan çocuk ve ergenlerde metabolik sendrom ve özellikleri

Amaç: Metabolik sendrom (METs) santral yağlanma, yüksek tansiyon, düşük seviyede yüksek yoğunluklu lipopro- tein (HDL) kolesterol, yükselmiş trigliserit(TG) ve hiperglisemi gibi bir dizi risk etkeninin birlikteliği şeklinde tanım- lanır. Metabolik sendrom yaygınlığı yetişkin popülasyonda birçok psikopatoloji ile hem artan belirti şiddeti düzeyin- de, hem de antidepresan kullanımı ile ilişkilendirilmiştir. Çalışmamızda duygudurum ve psikotik bozukluğu olan çocuk ve ergenlerde METs özellikleri ve METs oluşumunda var olan psikiyatrik bozuklukların ve psikotrop kullanı- mının etkilerini araştırmayı amaçladık. Yöntem: Çalışmaya Ruhsal bozuklukların Tanısal ve Sayımsal El kitabı, yeniden gözden geçirilmiş dördüncü baskısı (DSM-IV-TR) tanı ölçütlerine göre bipolar bozukluk, şizofreni, şizoaffek- tif bozukluk ve şizofreniform bozukluğu olan 13-20 yaşları arasındaki 30 hasta ve psikiyatrik bozukluğu olmayan 30 sağlıklı kontrol grubu çocuk ve ergen alınmıştır. Katılımcıların antropometrik ölçümleri (vücut ağırlığı, boy, bel çevresi, beden kitle indeksi-BKİ) yanında kan basıncı ölçümleri yapılmıştır. Katılımcıların total kolesterol, trigliserit, HDL, düşük yoğunluklu lipoprotein (LDL) değerleri ve açlık kan şekeri (AKŞ) düzeyleri ölçülerek, tüm verilerin değer- lendirilmesi sonucunda METs tanısı International Diabetes Foundation (IDF) ölçütleri temel alınarak konulmuştur. Bulgular: Çalışmamızda tüm örneklem grubumuzda METs oranı %20 (n=12) olarak belirlendi. Bunlardan dokuzu (%27) olgu grubunda, üçü (%10) kontrol grubunda idi. METs grubunun BKİ değeri, ortalama ağırlık, bel çevresi uzunluğu, serum trigliserit ve AKŞ değerleri kontrol grubundan istatistiksel olarak yüksek bulunmuştur. Ayrıca duygudurum düzenleyici ilaçların kullanımının METs gelişmesine istatistiksel olarak anlamlı bir etkisi olduğu saptan- mıştır. Sonuç: Çalışmamızda çocuk ve ergenlerde psikiyatrik bozuklukların ve antipsikotik kullanımının metabolik düzenlemeyi bozduğu ve METs için risk oluşturduğu belirlenmiştir. Bulgularımızın özellikle METs açısından risk taşıyan çocuk ve ergenlerde antipsikotik kullanımına yeni yaklaşımlar sağlayacağı kanısındayız. (Anadolu Psikiyatri Derg 2019; 20(1):76-83)

Metabolic syndrome and features in children and adolescents diagnosed with mood disorders and psychotic disorders

Objective: Metabolic syndrome (METS) is described as cluster of risk factors including central obesity, hyperten- sion, low high-density lipoprotein (HDL), hypertriglyceridemia and hyperglycemia. The prevalence of METs has been associated with increased symptom severity and antidepressants utilization in many psychopathologies among adult population. We aimed to evaluate the effect of psychopathologies and antipsychotics in METs devel- opment, additionally to determine METs characteristics in children and adolescents diagnosed with bipolar and psychotic disorders. Methods: Thirty children and adolescents aged between 13-20 years old of whom were diag- nosed with bipolar mood disorders, schizophrenia, schizoaffective disorder and schizophreniform according to Diag- nostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR) criteria were compared with a 30 healthy children and adolescents in present study. The anthropometric measurements including body weight, height, body mass index (BMI), waist circumference (WC) as well as blood pressure measurements were documented. In addition, total cholesterol, triglyceride (TG), HDL, low-density lipoprotein (LDL) and fasting blood glucose (FBG) levels were measured and METs assessed according to the IDF (International Diabetes Foundation) criteria in participants. Results: Overall the prevalence of METs was 20% (n=12) in our study. Among the METs patients, nine were (27%) in the case group, three were (10%) were in control group. The mean BMI, body weight, WC, serum TG and FBG values of the METs group were found to be statistically higher than the healthy control group. Moreover it was also found that utilization of mood-stabilizing drugs has a statistically significant effect on the development of METs. Conclusion: Psychopathologies and antipsychotic utilization have associated with an increased risk for the development of metabolic disorders and METs in the children and adolescents population. In this respect our findings may provide a new approach with the management of treatment strategies particularly in children and adolescents with high risk of METs. (Anatolian Journal of Psychiatry 2019; 20(1):76-83)

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