瘦素基因-2548G/A多态性与抗精神病药物长期治疗后发生2型糖尿病的关联分析  

The Association of Leptin Gene -2548G/A Functional Polymorphism with Antipsychotic Agent-induced Type 2 Diabetes in Schizophrenic Patients.

作　　者：孙静[1] 张志珺[1] 牟晓冬[1] 王从杰 张晓斌 

机构地区：[1]南京医科大学附属脑科医院,南京210029 [2]江苏省淮阴第三人民医院,223001 [3]江苏省扬州五台山医院,225003

出　　处：《中国心理卫生杂志》2005年第11期766-768,共3页Chinese Mental Health Journal

基　　金：国家自然科学基金资助项目(30170344)

摘　　要：目的:探讨瘦素基因启动子区-2548G/A多态性与抗精神病药物(APS)长期治疗后发生2型糖尿病的相关性。方法:110例病程>5年的慢性精神分裂症患者接受糖尿病流行病学调查,测定空腹血糖、餐后两小时血糖、空腹血浆瘦素和空腹血浆胰岛素水平。根据血糖水平及糖尿病临床症状,分为糖尿病组(DM组)、血糖调节异常组(AGT组,包括空腹血糖过高和葡萄糖耐量异常者)和血糖正常组(NGT组)。采用瘦素基因-2548G/A多态性的(RFLP)分析结果进行基因分型。结果:长期抗精神病药治疗的精神分裂症患者DM组、AGT组、NGT组瘦素基因-2548G/A多态性的各基因型频率分布差异有显著性,DM组患者更多表达为-2548AA基因型(X2=10.56,P=0.005);等位基因频率在三组间的分布差异具有显著性("2=6.24,P=0.044);瘦素水平在-2548AA与-2548AG基因型间差异有显著性(F=3.015,P=0.019)。结论:瘦素基因启动子区-2548G/A多态性可能与长期使用APS的精神分裂症患者发生糖尿病存在关联。Objective： To investigate whether antipsychotic agent-induced type 2 diabetes was associated with leptin gene -2548G/A functional polymorphism in schizophrenia patients who had treated by antipsychotics chronically. Methods： Fasting plasma glucose, 2-hour post meal plasma glucose, fasting plasma leptin and fasting plasma insulin were measured in 110 patients with chronic schizophrenia whose natural courses of the disorder were more than 5 years. According to the level of plasma glucose, these patients were divided into three groups, diabetes mellitus group, abnormal regulating glucose group and normal glucose group. The polymorphisms in the leptin promoter region （-2548 G/A） were determined with PCR-RFLP in the patients. Results： The patients in DM group were more likely to be homozygous for the -2548AA genotype. As compared with the patients with -2548AG/GG combined genotype, the patients with -2548AA genotype had significant increase in the level of plasma leptin （ P=0. 019 ）. Conclusion： The -2548G/A polymorphism in promoter region of leptin gene may be associated with type 2 diabetes in schizophrenic patients treated by antipsychotics chronically. -2548A allele ofleptin gene may be a genetic risk factor for the development of type 2 diabetes during antipsychotic treatment.

关 键 词：抗精神病药物 2型糖尿病 病例对照研究 空腹血浆瘦素 瘦素基因-2548A/G多态性 

分 类 号：R749.05[医药卫生—神经病学与精神病学]