ABCB1基因多态性与精神分裂症患者经奥氮平治疗后糖脂代谢水平的相关性  

Effect of ABCB1 gene polymorphism on glucose and lipid metabolism in patients with schizophrenia after olanzapine treatment

作　　者：肖旭东[1] 赵静[1] 金志兴[1] 陆佳瑞[1] 张莉[1] 巫珺[1] 孙扬[1] 陆颖[1] 龙彬[1] 朱丽萍[1] Xiao Xudong;Zhao Jing;Jin Zhixing;Lu Jiarui;Zhang Li;Wu Jun;Sun Yang;Lu Ying;Long Bin;Zhu Liping(Psychiatry Department,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 201108,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心临床精神科,201108

出　　处：《神经疾病与精神卫生》2020年第6期395-400,共6页Journal of Neuroscience and Mental Health

基　　金：上海市科学技术委员会科研计划项目(16401934700,17401932600,19401932300);上海市卫生健康委员会中医重点专科培育项目;上海市精神卫生中心院级课题(2017-YJ-06,2018-YJ-09)。

摘　　要：目的探讨精神分裂症患者ABCB1基因多态性与经奥氮平治疗后体重、血糖、血脂变化的相关性。方法前瞻性入组2017年7月至2018年12月住院的精神分裂症患者72例,单一服用奥氮平。采用Taqman探针基因分型技术对ABCB1基因rs1045642、rs2032582多态性进行分型。应用重复测量方差分析比较ABCB1基因rs1045642、rs2032582位点不同基因型间在基线期、治疗8周后体重、血糖、总胆固醇、甘油三酯、高密度脂蛋白(HDL)、低密度脂蛋白水平变化的差异。结果rs1045642位点CC基因型患者治疗后较基线期体重增加、空腹血糖下降,差异均有统计学意义[分别为(62.76±9.42)kg比(58.95±12.03)kg,t=10.040,P<0.05;(5.08±1.28)mmol/L比(6.33±2.38)mmol/L,t=7.268,P<0.05],而CT、TT基因型患者治疗前后差异均无统计学意义(均P>0.05);rs1045642位点CC、TT基因型治疗后较基线期HDL下降[分别为(1.12±0.30)mmol/L比(1.31±0.57)mmol/L,t=6.530,P<0.05;(1.36±0.23)mmol/L比(1.54±0.19)mmol/L,t=10.161,P<0.05],差异均有统计学意义,而CT基因型治疗前后差异无统计学意义(P>0.05)。rs2032582位点GG、TT基因型治疗后较基线期体重均增加[(62.57±10.61)kg比(59.23±12.20)kg,t=6.159,P<0.05;(60.19±6.93)kg比(57.31±8.97)kg,t=5.188,P<0.05],差异有统计学意义,GT基因型治疗前后差异无统计学意义(P>0.05);GG基因型治疗后较基线期血糖、HDL下降[分别为(5.19±1.39)mmol/L比(6.44±2.56)mmol/L,t=5.220,P<0.05;(1.18±0.30)mmol/L比(1.39±0.58)mmol/L,t=5.576,P<0.05],差异均有统计学意义,而GT、TT基因型治疗前后差异均无统计学意义(均P>0.05)。结论ABCB1基因多态性可能与精神分裂症患者经奥氮平治疗后体重增加、血脂代谢异常有相关性。Objective To investigate the relationship between ABCB1 gene polymorphism and the changes of body weight,blood glucose and blood lipids after olanzapine treatment in patients with schizophrenia.Methods A total of 72 patients with schizophrenia were prospectively enrolled in the study group from July 2017 to December 2018,who were treated with olanzapine alone.The rs1045642 and rs2032582 polymorphisms of ABCB1 gene were genotyped by Taqman probe genotyping technique.Repeated measurement analysis of variance was used to compare the changes of body weight,blood glucose,total cholesterol,triglyceride,high density lipoprotein(HDL)and low density lipoprotein between different genotypes of ABCB1 gene rs1045642 and rs2032582 at baseline and 8 weeks after treatment.Results(1)Repeated measurement analysis of variance results showed that CC genotype of rs1045642 locus had significant difference in weight gain and decrease of fasting blood glucose before and after treatment,which was statistically significant[(62.76±9.42)kg vs(58.95±12.03)kg,t=10.040,P<0.05;(5.08±1.28)mmol/L vs(6.33±2.38)mmol/L,t=7.268,P<0.05],but differences in CT and TT genotypes before and after treatment(All P>0.05)were not statistically significant.After treatment,the HDL of CC and TT genotypes of rs1045642 decreased compared with those at baseline[1.12±0.30)mmol/L vs(1.31±0.57)mmol/L,t=6.530,P<0.05;(1.36±0.23)mmol/L vs(1.54±0.19)mmol/L,t=10.161,P<0.05],which were both statistically significant.However,differences between before and after CT genotype treatment(P>0.05)were not statistically significant.(2)Single effect analysis showed that compare with baseline GG and TT genotypes of rs2032582 locus both had weight gain after treatment[(62.57±0.61)kg vs(59.23±12.20)kg,t=6.159,P<0.05;(60.19±6.93)kg vs(57.31±8.97)kg,t=5.188,P<0.05],which were statistically significant.But differences in GT genotypes before and after treatment were not statistically significant(P>0.05).Compare with baseline,blood glucose and HDL in GG genotypes decreased after t

关 键 词：精神分裂症 基因多态性 ABCB1 体重 血脂代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]