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【drug-news】退伍军人卫生管理局的精神分裂症患
原文标题：
Diabetes Risk Associated with Use of Olanzapine, Quetiapine, and Risperidone in Veterans Health Administration Patients with Schizophrenia
原文摘要：
To evaluate risk of new-onset type 2 diabetes associated with use of selected antipsychotic agents, the authors conducted a new-user cohort study in a national sample of US Veterans Health Administration patients with schizophrenia (and no preexisting diabetes). The authors studied 15,767 patients who initiated use of olanzapine, risperidone, quetiapine, or haloperidol in 1999–2001 after at least 3 months with no antipsychotic prescriptions. Patients were followed for just over 1 year. New-onset diabetes was identified through diagnostic codes and prescriptions for diabetes medication. In Cox proportional hazards regression adjusting for potential confounders, with patients initiating haloperidol use designated the reference group, diabetes risk was increased equally with new use of olanzapine (hazard ratio (HR) = 1.64, 95% confidence interval (CI): 1.22, 2.19), risperidone (HR = 1.60, 95% CI: 1.19, 2.14), or quetiapine (HR = 1.67, 95% CI: 1.01, 2.76). Diabetes risks were higher in patients under age 50 years. When data were reanalyzed with prevalent-user cohorts and matched case-control designs, results were similar, with slightly less elevated risk estimates. Assuming that the observed associations are causal, approximately one third of new cases of diabetes may be attributed to use of olanzapine, risperidone, and quetiapine in patients taking these medications. Prescribers should be mindful of diabetes risks when treating patients with schizophrenia. Diabetes Risk Associated with Use of Olanzapine, Quetiapine, and Risperidone in Veterans Health Administration Patients with Schizophrenia
退伍军人卫生管理局的精神分裂症患者罹患糖尿病的风险与使用奥氮平、喹硫平、利培酮的关系
To evaluate risk of new-onset type 2 diabetes associated with use of selected antipsychotic agents, the authors conducted a new-user cohort study in a national sample of US Veterans Health Administration patients with schizophrenia (and no preexisting diabetes).
为评价新发生的2型糖尿病与使用选择性安定药的关系，笔者在美国退伍军人卫生管理局抽取了全国性的精神分裂症患者（先前无糖尿病）的样本，对新进用药者群体进行研究。
The authors studied 15,767 patients who initiated use of olanzapine, risperidone, quetiapine, or haloperidol in 1999–2001 after at least 3 months with no antipsychotic prescriptions.
笔者研究了15767位患者，这些患者开始使用奥氮平、喹硫平、利培酮，或者是在至少3个月未用处方安定药后于1999-2001年使用氟哌丁苯的。
Patients were followed for just over 1 year.
并对病人进行了超过1年的追踪。
New-onset diabetes was identified through diagnostic codes and prescriptions for diabetes medication.
其新发的糖尿病都是经过诊断鉴别并接受了糖尿病处方药物治疗的。
In Cox proportional hazards regression adjusting for potential confounders, with patients initiating haloperidol use designated the reference group, diabetes risk was increased equally with new use of olanzapine (hazard ratio (HR) = 1.64, 95% confidence interval (CI): 1.22, 2.19), risperidone (HR = 1.60, 95% CI: 1.19, 2.14), or quetiapine (HR = 1.67, 95% CI: 1.01, 2.76).
通过用Cox比例风险模型调整了混淆因素，并把开始使用氟哌丁苯的患者定为对照组，罹患糖尿病的风险增大，是与使用奥氮平(峰度系数(HR) = 1.64, 95%置信区间(CI): 1.22, 2.19)、喹硫平(HR = 1.60, 95% CI: 1.19, 2.14)或利培酮(HR = 1.67, 95% CI: 1.01, 2.76)相当的。
Diabetes risks were higher in patients under age 50 years.
而其罹患糖尿病的风险高于50岁以下的病人。
When data were reanalyzed with prevalent-user cohorts and matched case-control designs, results were similar, with slightly less elevated risk estimates.
当这些数据与使用传统药物的群体再分析，并与对照设计配对时，所得的结果则是类似的，风险仅有微小的提升。
Assuming that the observed associations are causal, approximately one third of new cases of diabetes may be attributed to use of olanzapine, risperidone, and quetiapine in patients taking these medications.
假设这些观察结果是有因果关系的，那么大约三分之一的新发糖尿病就可能要归咎于患者使用了奥氮平、喹硫平和利培酮。
Prescribers should be mindful of diabetes risks when treating patients with schizophrenia.
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作者:admin@医学,生命科学 2010-11-25 15:14
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