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2014 | 14 | 4 | 290-295
Article title

Wpływ leków przeciwpsychotycznych na występowanie zespołu metabolicznego

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Title variants
EN
Effects of antipsychotic drugs on the occurrence of metabolic syndrome
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Abstracts
EN
Metabolic syndrome is a group of concomitant disorders that increase the risk of heart attack, stroke and diabetes. In Europe metabolic syndrome is defined using the IDF (International Diabetes Federation) criteria. According to these criteria, metabolic syndrome is the co-occurrence of abdominal (central, visceral) obesity, defined as abdomen circumference ≥80 cm in women and ≥94 cm in men plus two out of four criteria: 1) level of triglycerides >1.7 mmol/l (150 mg/dl) or treatment of triglyceridemia; 2) level of HDL cholesterol <1.0 mmol/l (40 mg/dl) in men and <1.3 mmol/l (50 mg/dl) in women or treatment of this disorder; 3) systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg or treatment of previously diagnosed hypertension; 4) fasting plasma glucose ≥5.6 mmol/l (100 mg/dl) or treatment of previously diagnosed type 2 diabetes. Metabolic syndrome is 2–3 times more frequent in patients receiving antipsychotics. The presence of metabolic syndrome is associated with a 2–3 fold increased risk of death due to cardiovascular complications. Almost all antipsychotics increase the risk of metabolic syndrome and the greatest risk is that due to the most effective drugs (clozapine, olanzapine). In most cases metabolic complications of antipsychotic treatment is treatment-induced increase of appetite and weight gain, while for certain medications these complications may develop as a direct effect of antipsychotics. The vast majority of patients do not receive a proper treatment of metabolic disorders. Available treatment options for drug-induced weight gain are not very effective and very rarely used.
PL
Zespół metaboliczny to zbiór współwystępujących zaburzeń, które zwiększają ryzyko zawału serca, udaru i cukrzycy. W Europie do oceny zespołu metabolicznego stosuje się kryteria International Diabetes Federation. Zgodnie z nimi zespół metaboliczny to współobecność otyłości brzusznej (trzewnej, centralnej), zdefiniowanej jako obwód talii ≥80 cm u Europejek i ≥94 cm u Europejczyków, oraz dwóch spośród następujących czynników: 1) stężenia trójglicerydów >1,7 mmol/l (150 mg/dl) lub leczenia triglicerydemii; 2) stężenia cholesterolu frakcji HDL <1,0 mmol/l (40 mg/dl) u mężczyzn i <1,3 mmol/l (50 mg/dl) u kobiet lub leczenia tego zaburzenia lipidowego; 3) ciśnienia tętniczego skurczowego ≥130 mm Hg bądź rozkurczowego ≥85 mm Hg lub leczenia wcześniej rozpoznanego nadciśnienia; 4) stężenia glukozy w osoczu na czczo ≥5,6 mmol/l (100 mg/dl) lub rozpoznanej wcześniej cukrzycy typu 2. Zespół metaboliczny występuje 2–3-krotnie częściej u pacjentów otrzymujących leki przeciwpsychotyczne. Obecność zespołu metabolicznego wiąże się z 2–3-krotnie większym ryzykiem zgonu z powodu powikłań sercowo-naczyniowych. Niemal wszystkie leki przeciwpsychotyczne podnoszą ryzyko wystąpienia zespołu metabolicznego; dotyczy to w szczególności leków najskuteczniej działających (klozapina, olanzapina). Punktem wyjścia metabolicznych powikłań leczenia przeciwpsychotycznego jest wzrost łaknienia indukowany leczeniem, prowadzący do przyrostu masy ciała; powikłania te mogą się rozwijać wskutek bezpośredniego działania leków. Zdecydowana większość pacjentów nie otrzymuje właściwego leczenia zaburzeń metabolicznych. W przypadku polekowego przyrostu masy ciała dostępne opcje terapeutyczne są mało skuteczne i zbyt rzadko stosowane.
Discipline
Publisher

Year
Volume
14
Issue
4
Pages
290-295
Physical description
Contributors
References
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Document Type
article
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YADDA identifier
bwmeta1.element.psjd-092ab202-8c44-4f8e-bb60-49a3c5b5b079
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