Meta-analysis of glucose tolerance, insulin, and insulin resistance in antipsychotic-naïve patients with nonaffective psychosis

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• 作者：Anne Marie Greenhalgh^a ; Leticia Gonzalez-Blanco^b ; ^c ; Clemente Garcia-Rizo^c ; ^d ; ^e ; Emilio Fernandez-Egea^f ; ^g ; Brian Miller^h ; Miguel Bernardo Arroyo^c ; ^d ; ^e ; Brian Kirkpatrick^a ; ^{bkirkpatrick2@aol.com}
• 关键词：Schizophrenia ; Diabetes ; Antipsychotic-naï ; ve ; Insulin ; Glucose tolerance
• 刊名：Schizophrenia Research
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：179
• 期：Complete
• 页码：57-63
• 全文大小：966 K
• 卷排序：179

文摘

Some studies have suggested that antipsychotic-naïve patients with nonaffective psychosis (NAP) have glucose intolerance.AimsTo conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR).MethodWe identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts. We required studies to include subjects with nonaffective psychosis and control subjects.ResultsThere were 911 patients and 870 control subjects in the analysis of FG; their average ages were respectively 28.7 and 29.5 years. Significant differences were found for all four variables, with effect size estimates ranging from 0.21 to 0.58.ConclusionsAs a group, at the time of first clinical contact for psychosis, people with NAP have a slight increase in FG, which most of them maintain in the normal range despite a small increase in IR by secreting additional INS. When faced with a physiological challenge such as a glucose tolerance test or antipsychotics, they are no longer able to maintain a normal glucose concentration.