Clozapine이 혈당대사에 미치는 영향
The Effect of Clozapine on Blood Glucose Metabolism
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초록
최근 clozapine 투여후 당뇨병이 합병증으로 발생한 일련의 증례보고가 있어, 전형적 항정신병약물인 haloperidol 투여시와 비교해서 clozapine 투여시의 당뇨병과 내당능장애, 혈당최고치지연의 발생유무를 알아보고자 본 연구를 고안했다.경북대학교 병원 정신과에 입원중이거나 외래 통원 치료중인 환자중 clozapine 투여군 19명과 haloperdol 투여군 15명을 대상으로 8주동안 경구당부하검사를 실시하여 당뇨병, 내당능장애, 혈당최고치지연의 발생율을 평가하였다. Clozapine 투여군에서 2명이 중도에 탈락했고 haloperidol 투여군에서 5명이 탈락하여, 연구에 끝까지 참가한 사람은 clozapine 투여군 17명, halopridol 투여군 10명이었다. Clozapine 투여군의 유병기간이 현저하게 더 길었으나(p=0.0066) 성별, 연령, 체중, 체중증가, 과거치료기간 등은 두 군간에 유의한 차이가 없었다.
Abstract
This study was performed to determine if there is an increased risk of diabetes mellitus and/or impaired glucose tolerance and/or glycemic peak delay during clozapine treatment compared with haloperidol treatment. Oral glucose tolerance tests were used for 8 weeks to assess the prevalence of diabetes mellitus, impaired glucose tolerance and glycemic peak delay in 19 patients of the clozapine group compared with 15 patients of the haloperidol group. There were 2 dropouts in the clozapine group and 5 in the haloperidol group. So finally 17 patients in the clozapine group and 10 patients in the haloperidol group participated in this study. In the clozapine group, 6 patients(35%) had impaired glucose tolerance, and 7 patients(41%) had glycemic peak delay. In the haloperidol group, no patient(0%) had impaired glucose tolerance, and 1 patient(10%) had glycemic peak delay. None of either group developed diabetes mellitus. In conclusion, subjects in the clozapine group had more impaired glucose tolerance and glycemic peak delay than subjects in the haloperidol group. However, this difference did not achieve statistical significance (p=0.056, p=0.079).