SMAD4基因多态性、早年创伤经历及其交互作用对强迫症患者临床症状的影响  

Effect of SMAD4 gene polymorphisms,early traumatic experience and their interactions on clinical features of patients with obsessive-compulsive disorder

作　　者：王佩[1] 赵青 许婷婷 王渊 王卫娣 范青[1] 韩慧琴 王振[1] Wang Pei;Zhao Qing;Xu Tingting;Wang Yuan;Wang Weidi;Fan Qing;Han Huiqin;Wang Zhen(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Psychological Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030 [2]复旦大学附属中山医院心理医学科,上海200032

出　　处：《中华行为医学与脑科学杂志》2025年第2期118-123,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(82071518);上海市精神卫生中心院级重点课题(2019-zd02)。

摘　　要：目的探讨SMAD家族成员4(SMAD4)基因多态性、早年创伤经历及其交互作用与强迫症患者临床特征的相关关系。方法本研究于2013年9月至2018年9月招募符合DSM-Ⅳ诊断标准的强迫症患者484例和符合入组标准的健康对照368例。采用Yale-Brown强迫量表(Y-BOCS)评估被试的强迫症状严重程度,贝克抑郁量表第Ⅱ版(BDI-Ⅱ)评估抑郁症状严重程度,贝克焦虑量表(BAI)评估焦虑症状严重程度,早年创伤问卷简表(ETI-SF)评估早年创伤经历。利用Taqman基因分型技术对SMAD4:rs12452684、rs2276163、rs17663887、rs3819122进行基因分型。采用SPSS 20.0软件进行数据分析,组间比较采用卡方检验、t检验、Mann-Whitney U检验和协方差分析。相关关系采用Spearman相关分析。交互作用采用一般线性模型分析。结果除rs17663887位点外,其余3个位点均符合Hardy-Weinberg平衡定律(rs12452684:χ^(2)=0.29,P=0.59;rs2276163:χ^(2)=2.58,P=0.11;rs3819122:χ^(2)=0.22,P=0.64)。SMAD4:rs12452684、rs2276163、rs3819122的等位基因、基因型频率在强迫症组和健康对照组间均差异无统计学意义(χ^(2)=0.02,1.20,0.04,均P>0.05;χ^(2)=1.85,3.98,1.45,均P>0.05);协方差分析(校正年龄、性别)结果显示,SMAD4:rs2276163、rs3819122两位点的3种基因型间的强迫行为评分[CC:(12.47±4.23)分,CT:(12.53±4.15)分,TT:(13.97±3.11)分;AA:(12.63±4.08)分,AC:(12.49±4.19)分,CC:(13.87±2.93)分]及Y-BOCS总分[CC:(25.31±6.42)分,CT:(25.68±5.90)分,TT:(27.75±6.01)分;AA:(25.54±6.52)分,AC:(25.56±5.98)分,CC:(27.63±5.75)分]差异有统计学意义(F=3.58,3.87,3.48,3.73,均P<0.05);ETI-SF中的情感虐待与强迫思维评分及Y-BOCS总分呈正相关(r=0.14,0.14,均P<0.05);rs2276163、rs3819122两位点的交互作用及分别与情感虐待的交互作用与强迫思维评分存在关联(F=4.65,3.63,2.93,均P<0.01)。结论早年经历的情感虐待越多则强迫症状越严重,SMAD4基因与早年创伤经历及其两者的交互作用参与强�Objective To explore the correlation among SMAD4 gene polymorphisms,early life traumatic experience and their interactions with clinical feature of obsessive-compulsive disorder(OCD).MethodsTotally 484 OCD patients who met the DSM-Ⅳdiagnostic criteria and 368 health controls who met the enrollment criteria were recruited from September 2013 to September 2018.The Yale-Brown obsessive-compulsive scale(Y-BOCS)was used to assess the severity of obsessive-compulsive symptoms,the Beck depression inventoryⅡ(BDI-Ⅱ)was used to assess the severity of depressive symptoms,the Beck anxiety inventory(BAI)was used to assess the severity of anxiety symptoms,and early trauma inventory-short form(ETI-SF)was used to assess early traumatic experience.SMAD4:rs12452684,rs2276163,rs17663887 and rs3819122 were genotyped using the Taqman genotyping technique.Data were analyzed using SPSS 20.0 software,and comparisons among groups were performed using chi-square test,t-test,Mann-Whitney U non-parametric test and analysis of covariance.Correlation was analyzed using Spearman correlation analysis,and interactions were analyzed using general linear model.ResultsAll sites except rs17663887 met the Hardy-Weinberg equilibrium(rs12452684:χ^(2)=0.29,P=0.59;rs2276163:χ^(2)=2.58,P=0.11;rs3819122:χ^(2)=0.22,P=0.64).Allele,genotype frequencies of SMAD4:rs12452684,rs2276163 and rs3819122 were not statistically significant between the OCD and the health control groups(χ^(2)=0.02,1.20,0.04,all P>0.05;χ^(2)=1.85,3.98,1.45,all P>0.05).The results of covariance analysis(corrected for age and gender)showed that there were significantly differences in compulsion(CC:12.47±4.23,CT:12.53±4.15,TT:13.97±3.11;AA:12.63±4.08,AC:12.49±4.19,CC:13.87±2.93)and total Y-BOCS scores(CC:25.31±6.42,CT:25.68±5.90,TT:27.75±6.01;AA:25.54±6.52,AC:25.56±5.98,CC:27.63±5.75)among the three genotypes of the SMAD4:rs2276163 and rs3819122 between the two groups(F=3.58,3.87,3.48,3.73,all P<0.05).Emotional abuse in the ETI-SF was positively correlated with obsessi

关 键 词：强迫症 SMAD4 早年创伤 交互作用 

分 类 号：R74[医药卫生—神经病学与精神病学]