5년 동안 추적한 만성 조현병 환자에서 대사증후군의 예측인자 = Predictors of Metabolic Syndrome in Chronic Schizophrenic Patients Followed for 5 Years(2011-2016)

국문 초록 (Abstract)

연구목적 본 연구는 대사증후군의 예방과 회복을 위해 5년 동안 추적이 가능한 만성 조현병 환자에서 대사증후군의 변화와 예측인자를 조사하였다. 방 법 2011년부터 2016년까지 추적이 가능하며 동의서에 동의한 107명의 환자가 본 연구에 포함되었다. Revised National Cholesterol Education Program-Adult Treatment Panel III(NCEP-ATP III)를 이용하여 대사증후군을 정의하였다. 결 과 추적 관찰 기간 동안 22명(20.5%)의 환자가 새롭게 대사증후군에 진단되었고 14명(13.1%)는 대사증후군에서 회복되었다. 77명(66.4%)은 변화가 없었다(대사증후군이 있는 환자:34명[31.8%], 대사증후군이 없는 환자 : 37명[34.6%]). 복부둘레와 중성 지방이 대사증후군의 유무가 변화된 환자들에서 중요한 인자였다. 다른 변수를 통제한 다변량 회귀분석에서 여성(OR=2.846, 95% C.I. 1.020-7.942), 1달에 1회 이상 외래 방문(OR=3.155, 95% C.I. 1.188-8.379), 항우울제 병합치료(OR=3.991, 95% C.I. 1.048-15.205)가 대사증후군의 유병률에 유의한 영향을 주었다. 반면에 항정신병 약물의 종류나 용량은 대사증후군의 유병률에 영향을 주지 못했다. 결 론 만성 조현병 환자에서 약제의 변경 및 용량조절보다 증상에서의 회복과 건강한 생활 습관이 대사증후군에 중요하다.

다국어 초록 (Multilingual Abstract)

Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

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