Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
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2018
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بررسی تغییر شاخص های سندرم متابولیک در بیماران بستری
در بخش روانپزشکی
Changes in the Indicators of Metabolic Syndrome in Hospitalized Psychiatric Patients
روانپزشکی
psychiatry
پژوهشي-کامل
Research(Original)
<p dir="RTL" style="margin: 0px 0px 10.66px; text-align: right; unicode-bidi: embed; direction: rtl;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" style="margin: 0px; line-height: 107%; font-family: F_Lotus; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="RTL"></span><span style="margin: 0px;" dir="RTL"></span><span b="" lang="AR-SA" style="margin: 0px; line-height: 107%; font-family: "><span style="margin: 0px;" dir="RTL"></span><span style="margin: 0px;" dir="RTL"></span></span></p>
<span style="letter-spacing:-.1pt;"><span style="color:black;"><span style="font-family:b koodak;">سابقه</span></span></span><span style="letter-spacing:-.1pt;"><span style="color:black;"><span style="font-family:b koodak;"> و هدف:</span></span></span> <span style="font-family:b zar;">سندرم متابولیک، عامل خطرسازی در بیمارهای قلبی عروقی می</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">باشد.</span> <span style="font-family:b zar;">هدف این مطالعه</span><span style="font-family:b zar;"> شناختن تغییرات شاخص</span><span dir="LTR"><span style="font-size:10.0pt;"></span></span><span style="font-family:b zar;">های مختلف این سندرم در دوره بستری در بخش</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">های روانپزشکی است که می</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">توان با پیشگیری زودرس، موجب کاهش خطر ابتلا به این سندرم شد.</span><br>
<span style="letter-spacing:-.1pt;"><span style="color:black;"><span style="font-family:b koodak;">مواد و روش</span></span></span><span dir="LTR" style="letter-spacing:-.1pt;"><span style="color:black;"><span style="font-size:10.0pt;"></span></span></span><span style="letter-spacing:-.1pt;"><span style="color:black;"><span style="font-family:b koodak;">ها:</span></span></span> <span style="font-family:b zar;">مطالعه از نوع مقطعی بود که </span><span style="font-family:b zar;">۱۵۲</span><span style="font-family:b zar;"> بیمار با اختلالات روانپزشکی که در زمستان سال 1395 در بیمارستان زارع ساری بستری شدند، در زمان ورود آزمایشات قند خون ناشتا، کلسترول </span><span dir="LTR"><span style="font-size:10.0pt;">HDL</span></span><span style="font-family:b zar;">، تری گلیسرید اخذ و وزن و دور کمر و فشار خون بیماران درج گردید، تمام مراحل مذکور حین ترخیص از بخش نیز انجام گرفت.</span><br>
<span style="letter-spacing:-.2pt;"><span style="color:black;"><span style="font-family:b koodak;">یافته</span></span></span><span dir="LTR" style="letter-spacing:-.2pt;"><span style="color:black;"><span style="font-size:10.0pt;"></span></span></span><span style="letter-spacing:-.2pt;"><span style="color:black;"><span style="font-family:b koodak;">ها:</span></span></span> <span style="letter-spacing:-.3pt;"><span style="font-family:b zar;">در میان بیماران اسکیزوفرنیا، تغییرات در مورد شاخص</span></span><span style="letter-spacing:-.3pt;"><span style="font-family:b zar;"></span></span><span style="letter-spacing:-.3pt;"><span style="font-family:b zar;">های دور کمر (000/0= </span></span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">p</span></span><span style="letter-spacing:-.3pt;"><span style="font-family:b zar;">) و تری</span></span><span style="letter-spacing:-.3pt;"><span style="font-family:b zar;"></span></span><span style="letter-spacing:-.3pt;"><span style="font-family:b zar;">گلیسیرید (010/0= </span></span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">p</span></span><span style="letter-spacing:-.3pt;"><span style="font-family:b zar;">)</span></span><span style="font-family:b zar;"> معنی</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">دار بود، در بیماران دوقطبی علاوه بر این اندکس</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">ها، تغییرات در مورد </span><span dir="LTR"><span style="font-size:10.0pt;">HDL</span></span><span style="font-family:b zar;"> هم از لحاظ آماری معنادار </span><br>
<span style="font-family:b zar;">بود</span><span style="font-family:b zar;"> (045/0، 004/0، 017/0</span><span dir="LTR"><span style="font-size:10.0pt;">p=</span></span><span style="font-family:b zar;">). در بیماران اسکیزوافکتیو تغییر شاخص</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">های قندخون ناشتا (013/0= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b zar;">)</span><span style="font-family:b zar;"> و دور کمر (018/0= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b zar;">)</span><span style="font-family:b zar;"> از لحاظ آماری معنادار بود. در بیماران اختلالات وابسته به مصرف مواد هیچ تغییر معنی</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">دار در هیچ شاخصی دیده نشد. در مورد اختلالات سایکوتیک گذرا فقط تغییر در شاخص دورکمر (005/0= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b zar;">)</span><span style="font-family:b zar;"> معنادار بوده است.</span><br>
<span style="letter-spacing:-.2pt;"><span style="color:black;"><span style="font-family:b koodak;">استنتاج:</span></span></span> <span style="font-family:b zar;">تغییر در شاخص</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">های سندرم متابولیک بسیار شایع</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">تر از شیوع سندرم متابولیک می</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">باشد و شاخص</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">هایی که آسیب</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">پذیرتر بوده و می</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">توان از آن</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">ها برای غربالگری جهت پیشگیری از ابتلا به این سندرم استفاده کرد شامل دورکمر و سطح تری</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">گلیسیرید می</span><span style="font-family:b zar;"></span><span style="font-family:b zar;">باشد.</span><br>
<p dir="RTL" style="margin: 0px 0px 10.66px; text-align: right; unicode-bidi: embed; direction: rtl;"><span style="margin: 0px;" dir="RTL"></span><span style="margin: 0px;" dir="RTL"></span><span b="" lang="AR-SA" style="margin: 0px; line-height: 107%; font-family: "><span style="margin: 0px;" dir="RTL"></span><span style="margin: 0px;" dir="RTL"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span><span dir="LTR" lang="AR-SA" style="margin: 0px; line-height: 107%; font-size: 12pt;"><span style="margin: 0px;" dir="LTR"></span><span style="margin: 0px;" dir="LTR"></span></span></p>
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<strong>Background and purpose:</strong> Metabolic syndrome includes a series of risk factors for cardiovascular diseases. The aim of this study was to identify the changes in various indicators of this syndrome during hospitalization in a psychiatric department. Identifying these changes could help in reducing the risk of this syndrome.<br>
<strong>Materials and methods:</strong> A cross-sectional study was conducted in 152 patients with psychiatric disorders who were admitted in Sari Zare Hospital, winter 2016. Fasting blood glucose (FBS), HDL-cholesterol, triglyceride (TG), weight, waist circumference, and blood pressure were recorded at the time of hospital admission and discharge.<br>
<strong>Results:</strong> Compared to the time of hospital admission, significant changes were seen in waist circumference (p=0.000) and TG (p=0.010) among schizophrenic patients at the time of hospital discharge. In patients with bipolar disorder, significant changes were found in waist circumference, TG, and also HDL at the time of hospital discharge (p= 0.017, 0.004, 0.045). Moreover, we found significant changes in FBS and waist circumference in patients with schizoaffective disorder (p=0.013 and p=0.018, respectively). In patients with substance use, no significant changes were seen in any of the indicators when being discharged from hospital. But patients with brief psychotic disorder showed significant changes only in waist circumference (p=0.005).<br>
<strong>Conclusion:</strong> Changes in the indicators of metabolic syndrome are much more common than the prevalence of metabolic syndrome. Indicators that are more likely to change during hospitalization and could be used in screening for prevention of metabolic syndrome include waist circumference and TG levels.<br>
بیمارستان, روانپزشکی, سندرم متابولیک
hospital, metabolic syndrome, psychiatry
109
118
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-8555-2&slc_lang=fa&sid=1
Javad
Setareh
جواد
ستاره