ObjectiveTo systematically evaluate the relationship between the-2548G/A polymorphism in the leptin gene and antipsychotic-induced weight gain (AIWG). MethodsLiterature for the relationship between the-2548G/A polymorphism in the leptin gene and AIWG was retrieved in electronic databases including PubMed, EMbase, CNKI and WanFang Data from establishment dates to June, 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 7 case-control studies were included, involving 404 AIWG cases and 508 controls (patients with no significant changes of weight after taking antipsychotic drugs). The results of meta-analysis showed that, regarding the total population, the-2548G/A polymorphism of the leptin gene was not associated with AIWG (OR=1.16, 95%CI 0.70 to 1.93, P=0.57). After stratification analysis, according to Chinese or non-Chinese origin, the results showed that significant association was found between the-2548G/A polymorphism of leptin gene and AIWG for Chinese (OR=2.15, 95%CI 1.41 to 3.26, P=0.000 4) but not for non-Chinese (OR=0.69, 95%CI 0.45 to 1.07, P=0.10). ConclusionThe current evidence suggests that the-2548G/A polymorphism in the leptin gene is associated with increased risk of AIWG for Chinese. Due to limited quantity of the included studies, the aforementioned conclusion needs to be further validate by more high-quality and large-scale studies.
ObjectivesTo systematically review the clinical efficacy and safety of antipsychotics for delirium. MethodsDatabases including The Cochrane Library (Issue 5, 2015), PubMed, MEDLINE, EMbase, CNKI, VIP and WanFang Data were electronically searched for randomized controlled trials (RCTs) about antipsychotics compared with placebo/blank for delirium from inception to May 2015. We also hand-searched related conference proceedings and references of included studies for additional studies. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was conducted by using RevMen 5.3 software. ResultsA total of 7 RCTs involving 712 patients were included. The results of meta-analysis showed that there were no significant differences between the antipsychotics group and the placebo/blank group in mortality (RR=1.00, 95%CI 0.90 to 1.10, P=0.99), duration of delirium (MD=-1.53, 95%CI -4.95 to 1.89, P=0.38), length of stay (MD=-0.89, 95%CI -7.69 to 5.90, P=0.80), and ICU stay time (MD=-3.70, 95%CI -15.83 to 8.43, P=0.55). Compared with the placebo/ blank group, the antipsychotics could reduce the severity of delirium (SMD=-1.62, 95%CI -2.32 to -0.93, P<0.000 01). ConclusionCurrent evidence shows that the efficacy of antipsychotics in the treatment of delirium is not clear. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.
Objective To investigate whether antipsychotic drugs will increase the risk of venous thromboembolism (VTE) and pulmonary embolism (PE), and to provide evidence for the prevention of VTE and PE in patients with APs exposure. Methods Databases including PubMed, Web of Science, CNKI, VIP and Elsevier were searched from inception to July 2016 to collect case-control studies and cohort studies on the association between APs exposure and the risk of VTE and PE. The literature were screened according to the inclusion and exclusion criteria, the data were extracted and the bias risk of the included studies were evaluated by two reviewers independently. The Meta-analysis was performed by using Stata 12 software. Results Nineteen studies were included. The results of meta-analysis showed that APs exposure was associated with VTE (OR=1.50, 95%CI 1.30 to 1.74,P<0.001). Exposure to low-potency FGA (OR=2.28, 95%CI 1.02 to 5.10,P=0.045), high-potency FGA (OR=1.68, 95%CI 1.37 to 2.05,P<0.001) and SGA (OR=1.74, 95%CI 1.24 to 2.44,P=0.001) revealed an increased risk of VTE. Exposure to APs also signi?cantly increase the risk of PE (OR=3.69, 95%CI 1.23 to 11.07,P=0.02), especially exposure to FGA (OR=2.54, 95%CI 1.22 to 5.32,P=0.013), but exposure to SGA could not revealed an increased risk of PE. Conclusion FGA and SGA exposure maybe associated with an increase in the risk of developing VTE. And exposure to the FGA could increase the risk of PE. The occurrence of VTE and PE should be monitored when taking Aps.