Abstract：
OBJECTIVE: Weight gain, blood lipids and/or glucose dysregulation can follow aripiprazole treatment onset. Whether aripiprazole dosage is associated with an increase in these metabolic parameters remains uncertain. The present study investigates aripiprazole dose associations with weight change, blood glucose, lipids, and blood pressure.
METHODS: 422 patients taking aripiprazole for a minimum of three weeks to one year were selected from PsyMetab and PsyClin cohorts. Associations between aripiprazole dose and metabolic outcomes were examined using linear mixed-effect models.
RESULTS: Aripiprazole dose was associated with weight change when considering its interaction with treatment duration (interaction term: -0.10, p < 0.001). This interaction resulted in greater weight gain for high versus low doses at the beginning of the treatment, this result being overturned at approximately five months, with greater weight increase for low versus high doses thereafter. LDL and HDL cholesterol levels were associated with aripiprazole dose over five months independently of treatment duration, with an average of 0.06 and 0.02 mmol/l increase for each 5 mg increment, respectively (p = 0.033 and p = 0.016, respectively). Furthermore, mean dose increases were associated with greater odds (+30 % per 5 mg increase) of clinically relevant weight gain (i.e., ≥7 %) over one year (p = 0.025).
CONCLUSIONS: Aripiprazole dose was associated with one-year weight changes when considering its interaction with treatment duration. Increasing its dose could lead to metabolic worsening over the first five months of treatment, during which minimum effective doses should be particularly preferred.
METHODS: 422 patients taking aripiprazole for a minimum of three weeks to one year were selected from PsyMetab and PsyClin cohorts. Associations between aripiprazole dose and metabolic outcomes were examined using linear mixed-effect models.
RESULTS: Aripiprazole dose was associated with weight change when considering its interaction with treatment duration (interaction term: -0.10, p < 0.001). This interaction resulted in greater weight gain for high versus low doses at the beginning of the treatment, this result being overturned at approximately five months, with greater weight increase for low versus high doses thereafter. LDL and HDL cholesterol levels were associated with aripiprazole dose over five months independently of treatment duration, with an average of 0.06 and 0.02 mmol/l increase for each 5 mg increment, respectively (p = 0.033 and p = 0.016, respectively). Furthermore, mean dose increases were associated with greater odds (+30 % per 5 mg increase) of clinically relevant weight gain (i.e., ≥7 %) over one year (p = 0.025).
CONCLUSIONS: Aripiprazole dose was associated with one-year weight changes when considering its interaction with treatment duration. Increasing its dose could lead to metabolic worsening over the first five months of treatment, during which minimum effective doses should be particularly preferred.
摘要：
目的：体重增加，血脂和/或血糖失调可以跟随阿立哌唑治疗开始.阿立哌唑剂量是否与这些代谢参数的增加相关仍不确定。本研究调查了阿立哌唑剂量与体重变化的关系，血糖，脂质，还有血压.
方法：从PsyMetab和PsyClin队列中选择422名服用阿立哌唑至少3周至1年的患者。使用线性混合效应模型检查阿立哌唑剂量与代谢结果之间的关联。
结果：阿立哌唑剂量与体重变化有关，当考虑其与治疗持续时间的相互作用时（相互作用项：-0.10，p<0.001）。在治疗开始时，这种相互作用导致高剂量与低剂量的体重增加更大。这个结果在大约五个月时被推翻了，此后，低剂量与高剂量的体重增加更大。LDL和HDL胆固醇水平与阿立哌唑剂量在5个月内独立于治疗持续时间相关。每增加5毫克，平均增加0.06和0.02毫摩尔/升，分别(p=0.033和p=0.016)。此外，平均剂量增加与临床相关体重增加的几率更大(每5毫克增加+30%)相关(即，≥7%)超过一年(p=0.025)。
结论：当考虑阿立哌唑剂量与治疗持续时间的相互作用时，阿立哌唑剂量与一年体重变化相关。增加剂量可能会导致治疗前五个月的代谢恶化，在此期间，应特别优选最低有效剂量。
方法：从PsyMetab和PsyClin队列中选择422名服用阿立哌唑至少3周至1年的患者。使用线性混合效应模型检查阿立哌唑剂量与代谢结果之间的关联。
结果：阿立哌唑剂量与体重变化有关，当考虑其与治疗持续时间的相互作用时（相互作用项：-0.10，p<0.001）。在治疗开始时，这种相互作用导致高剂量与低剂量的体重增加更大。这个结果在大约五个月时被推翻了，此后，低剂量与高剂量的体重增加更大。LDL和HDL胆固醇水平与阿立哌唑剂量在5个月内独立于治疗持续时间相关。每增加5毫克，平均增加0.06和0.02毫摩尔/升，分别(p=0.033和p=0.016)。此外，平均剂量增加与临床相关体重增加的几率更大(每5毫克增加+30%)相关(即，≥7%)超过一年(p=0.025)。
结论：当考虑阿立哌唑剂量与治疗持续时间的相互作用时，阿立哌唑剂量与一年体重变化相关。增加剂量可能会导致治疗前五个月的代谢恶化，在此期间，应特别优选最低有效剂量。
