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目的：探讨首发未用药(first-episode and drug-naïve, FEDN)精神分裂症患者体质量超标的影响因素。方法：选择2021年1月—2025年3月于南通市第四人民医院精神科住院的FEDN精神分裂症患者175例为研究对象，根据BMI值将患者分为BMI正常组(18.5～<24 kg/m2, n=102)及BMI超常组(≥24 kg/m2, n=73)，收集患者的一般资料及血清学指标，采用阳性与阴性症状量表(positive and negative syndrome scale, PANSS)评估患者的精神症状。比较两组患者临床资料的差异，采用二元多因素Logistic回归分析法，分析导致FEDN精神分裂症患者BMI异常的影响因素，并通过ROC曲线评价预测模型的诊断价值。结果：BMI超常组男性比例、病程、吸烟率、PANSS总分、阳性症状、阴性症状、总胆固醇(total cholesterol, TC)和三酰甘油(triglycerides, TG)及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)均高于BMI正常组，而受教育年限及高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)低于BMI正常组(P<0.05)。二元多因素Logistic回归分析显示，LDL-C(OR=2.561, 95%CI:1.426～4.598, P=0.002)是FEDN精神分裂症患者BMI超常的危险因素，HDL-C(OR=0.105, 95%CI:0.027～0.418, P=0.001)是保护因素。ROC曲线分析显示HDL-C及LDL-C联合指标对FEDN精神分裂症患者BMI超常具有良好的预测效能，且该效能优于上述指标单独使用时的预测效果。结论：脂代谢紊乱与FEDN精神分裂症患者体质量超标有关。
Abstract：Objective: To explore the influencing factors of overweight in first-episode and drug-naïve(FEDN) patients with schizophrenia. Methods: A total of 175 patients with FEDN patients with schizophrenia were enrolled from the Department of Psychiatry of Nantong Fourth People's Hospital from January 2021 to March 2025. Referring to the BMI values, the patients were divided into the normal BMI group(18.5-<24 kg/m2, n=102) and the elevated BMI group(≥24 kg/m2, n=73). General information and serological indicators of the patients were collected, while their psychiatric symptoms were assessed using the positive and negative syndrome scale(PANSS). On the basis of this, clinical parameter variations between the two groups were evaluated, and binary multivariate Logistic regression analysis was utilized to detect risk factors causing abnormal BMI in FEDN schizophrenia patients, and the diagnostic value of the prediction model was evaluated through the ROC curve. Results:The proportions of males and disease duration, smoking rate, PANSS total score, positive symptoms, negative symptoms, total cholesterol(TC), triglycerides(TG), and low-density lipoprotein cholesterol(LDL-C) in the elevated BMI group were all higher than those in the normal BMI group, while the years of education and high-density lipoprotein cholesterol(HDL-C) were lower than those in the normal BMI group(P<0.05). A binary multivariate Logistic regression analysis displayed that LDL-C(OR=2.561,95%CI: 1.426-4.598, P=0.002) was a risk factor for elevated BMI in FEDN schizophrenia patients, while HDL-C(OR=0.105,95%CI: 0.027-0.418, P=0.001) was a protective factor. ROC curve analysis showed that the combined index of HDL-C and LDL-C had good predictive efficacy for elevated BMI in FEDN schizophrenia patients, and this efficacy was superior to that of either index used alone. Conclusion: Dyslipidemia is associated with overeight in FEDN schizophrenia patients.
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基本信息:
DOI：10.16424/j.cnki.cn32-1807/r.2025.06.003
中图分类号:R749.3
引用信息:
[1]杨小玉,施燕妮,杨群,等.首发未用药精神分裂症患者体质量超标的影响因素研究[J].南通大学学报(医学版),2025,45(06):524-529.DOI:10.16424/j.cnki.cn32-1807/r.2025.06.003.
基金信息:
南通市卫生健康委员会面上项目(MS2024074); 江苏省卫健委老年健康科研面上课题(LKM2022062)