详细记录  
题名:Quetiapine Treatment in Youth Is Associated With Decreased Insulin Secretion.
作者:NGAI YF; SABATINI P; NGUYEN D; DAVIDSON J; CHANOINE JP; DEVLIN AM; LYNN FC; PANAGIOTOPOULOS C;
来源:J Clin Psychopharmacol. 2014 Mar 13. [ IF= 0.00 ] ]
URL :10.1097/JCP.0000000000000118
日期:20140408
摘要:Second-generation antipsychotics (SGAs) are commonly prescribed to youth but are
associated with metabolic effects including obesity and diabetes. The mechanisms
underlying diabetes development are unclear. The purpose of this study was to
compare glucose homeostasis, insulin sensitivity, insulin secretion, and overall
beta-cell function in risperidone-treated, quetiapine-treated, and SGA-naive
youth with mental illness. We conducted a cross-sectional study in which youth
aged 9 to 18 years underwent a 2-hour oral glucose tolerance test. Indices for
insulin sensitivity (Matsuda index), insulin secretion (insulinogenic index), and
beta-cell function (insulin secretion-sensitivity index-2 [ISSI-2]) were
calculated. A total of 18 SGA-naive, 20 risperidone-treated, and 16
quetiapine-treated youth participated. The 3 groups were similar in age, sex,
ethnicity, body mass index standardized for age and sex, pubertal status, degree
of psychiatric illness, psychiatric diagnoses, and other medications. The median
treatment duration was 17 months (range, 3-91 months) for risperidone-treated
youth and 10 months (range, 3-44 months) for quetiapine-treated youth. The
quetiapine-treated group had lower insulinogenic index (P < 0.01) and lower
ISSI-2 (P < 0.01) compared with that in the SGA-naive group. Only the body mass
index standardized for age and sex was negatively associated with Matsuda index
(beta = -0.540, P < 0.001) in all youth. Quetiapine treatment was negatively
associated with insulinogenic index (beta = -0.426, P = 0.007) and ISSI-2 (beta =
-0.433, P = 0.008). Quetiapine reduced the insulin expression in isolated mouse
islets suggesting a direct beta-cell effect. Our results suggest that quetiapine
treatment in youth is associated with impaired beta-cell function, specifically
lower insulin secretion. Prospective longitudinal studies are required to
understand the progression of beta-cell dysfunction after quetiapine initiation.

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