奥氮平治疗导致的体重增加和血糖、血脂升高与5-HT2A受体基因多态性的关系  

The Association between Polymorphism of 5HT2A Receptor Gene andOlanzapine induced Weight Gain

作　　者：刘琦[1] 周东丰[1] 周沫[1] 原岩波[1] 刘靖[1] 

机构地区：[1]北京大学精神卫生研究所,100083

出　　处：《中国心理卫生杂志》2003年第10期696-698,692,共4页Chinese Mental Health Journal

摘　　要：目的 :探讨奥氮平治疗患者的体重增加和血糖、血脂改变与 5 -羟色胺 2A受体 (HTR2A)基因多态性T10 2C和 -14 3 8G A的关系。方法 :采用PCR -RFLP技术分析 5 7名奥氮平治疗的精神分裂症患者的HTR2A基因多态性T10 2C和 -14 3 8G A的频率。测定患者治疗前后的体重、血脂和血糖指标 ,并计算体重指数 (BMI)。分析基因型与各指标变化的相关性。结果 :治疗后患者体重平均增加 ( 4 2± 4 2 )kg ,或增加基础体重的 ( 7 5± 7 6) % ,体重变化的范围为 ( -3～ 15 )kg ,平均BMI变化值为 ( 1 5± 1 5 )kg m2 ,空腹血糖平均增加 ( 0 3± 0 7)mmol L ,血清甘油三脂和胆固醇平均增加分别为 ( 0 73± 1 0 5 )mmol L和 ( 0 5 9±0 65 )mmol L。突变型纯合子 -14 3 8A A比野生型纯合子 -14 3 8G G的体重增加更显著。结论 :HTR2A受体与奥氮平导致的体重增加有关 ,基因型 -14 3 8A A可预示服用奥氮平后体重增加。Objective: To determine whether 5-hydroxytrytamine 2A (5HT2A) receptor gene T102C and -1438G/A polymorphism influences the weight gain and elevated serum glucose, triglyceride and cholesterol in patients treated with Olanzapine. Motheds: DNA was extracted from peripheral blood of 57 schizophrenia patients treated with Olanzapine. PCR-RELP technique was used to analyze the frequencies of 5HT2A receptor gene variants. All patients were treated at lest for 6 weeks, and the body weight, serum glucose, triglyceride and cholesterol were measured before and after 6-week therapy. The relation of variants and clinical features was analyzed. Result: After 8-week treatment, there was an average increase in body weight of (4.2±4.2) kg or (7.5±7.6)% of the baseline, with the range of (-3～15) kg. The average increase in BMI was (1.5±1.5) kg/m 2, in serum glucose was (0.3±0.7)mmol/L, in serum triglyceride was (0.73±1.05)mmol/L and in cholesterol was (0.59±0.65)mmol/L. The patients with genotype of wild homozygote -1438A/A gain more weight than those with -1438G/G. Conclusion: The 5HT 2A receptor gene -1438G/A polymorphism is associated with Olanzapine induced weight gain.

关 键 词：奥氮平 治疗 体重 血糖 血脂 5-HT2A 受体 基因多态性 精神病学 

分 类 号：R749[医药卫生—神经病学与精神病学]