瘦素受体基因3057G/A多态性与抗精神病药所致肥胖及高血压的关系  

Polymorphisms of leptin receptor gene 3057G/A associated with antipsychotics-related obesity and hypertension

作　　者：王从杰[1] 张志珺[2] 孙文婧[3] 孙静[4] 张向荣[4] 牟晓冬[2] 张晓斌 张太泉 

机构地区：[1]江苏省淮安市第三人民医院精神科,淮安223001 [2]东南大学附属中大医院神经科 [3]南京大学 [4]南京医科大学附属脑科医院精神科 [5]江苏省扬州五台山医院精神科 [6]江苏省苏州市精神病福利院

出　　处：《中国行为医学科学》2006年第11期989-991,共3页Chinese Journal of Behavioral Medical Science

基　　金：国家自然科学基金资助项目(30170344)

摘　　要：目的了解长期服用抗精神病药(APS)患者的瘦素受体基因3057G/A多态性,并探讨其与长期应用抗精神病药物治疗相关的肥胖、糖代谢及高血压的关系。方法入组84例长期应用APS的精神分裂症患者,采用常规酚/氯仿方法,提取基因组DNA,采用聚合酶链式反应-限制性片段长度多态性技术,检测瘦素受体基因3057G/A多态性和等位基因分布频率。采用放射免疫法测定血清胰岛素及瘦素水平。结果(1)长期使用抗精神病药患者的瘦素受体基因3057G/A位G→A变异频率为92.26%。(2)肥胖与非肥胖患者之间瘦素受体基因型分布及等位基因频率均差异无显著性(2值为5.23和1.04,均P>0.05)。(3)携带GA和AA型基因的患者之间的主要临床变量、发生糖耐量降低及2型糖尿病均差异无显著性(P>0.05),但携带AA型患者的血胆固醇水平趋向高于携带GA型患者[(4.74±1.01)mmol/Lvs(4.18±0.71)mmol/L](P值=0.08),且携带AA型患者收缩压显著高于携带GA型患者[(16.4±1.98)kPavs(15.5±0.60)kPa](P<0.05).(4)多元线形回归分析示瘦素受体基因3057G/A多态性与空腹血糖水平并不相关。结论瘦素受体基因3057G/A多态性与抗精神病药物治疗相关的肥胖、糖耐量降低和2型糖尿病无明显相关,不是影响分裂症患者肥胖和血糖代谢障碍的基因危险因子。携带AA型基因的精神分裂症患者更易于发生收缩压升高及脂质代谢障碍。Objective To analyse the polymorphisms of leptin receptor gene 3057 G/A in schizophrenic inpatients with long-term antipsychoties use, and study its associations with antipsychoties-related obesity impaired glucose tolerance （IGT）, type 2 diabetes mellitus （T2DM） and hypertension. Methods 84 schizophrenic inpatients with long-term antipsyehotics were involved in the study. Leptin receptor gene 3057 G/A polymorphisms and allele were determined with the polymerase chain reaction and restricted fragment length polymorphism assay. Ser- um insulin and leptin were measured with radioimmunoassay respectively. Results （ 1 ） The G→A variation of leptin receptor gene 3057 G/A in schizophrenic patients with long-term antipsyehotics was 92.26%, （2） The differences of leptin receptor genotypes and allele distribution between obesity and non-obesity group were not found（X^2 =5.23 and 1.04） （P〉0.05）, （3） The differences of major clinical variates and suffering from IGT, type 2 diabetes mellitus between genotype GA and AA were not found, but the serum cholesterol level in genotype AA patients were significantly close to higher than that in genotype GA[ （4.74 ± 1.01 ） mmol/L vs （4.18 ±0.71 ） mmol/L] （ P= 0.08 ）, and systolic pressure in patients with genotype AA was significantly higher than that in patients with genotype GA[ （16.4 ± 1.98）kPa vs （ 15.5 ±0, 60）kPa] （ P〈0. 05）. （4） Multiple linear regression analysis suggested polymorphisms of leptin receptor gene 3057G/A did not entry the equation that influenced fasting blood glucose level. Conclusions （ 1 ） The polymorphisms of leptin receptor gene 3057G/A were not associations with antipsychotics-related obesity, IGT, and T2DM, and it had not been considered as a gene predictors that influenced obesity and blood glucose metabolism in schizophrenia, （2） Schizophrenic patients with genotype AA trend to present in elevation of systolic pressure and lipid metabolic disturbances.

关 键 词：瘦素受体基因 多态性 抗精神病药 肥胖 

分 类 号：R595.3[医药卫生—内科学]