在控制生活事件与人格因素条件下探讨NET基因G1287A多态性和重型抑郁症关联性

Correlation between norepinephrine transporter gene G1287A polymorphism and major depression under controlled life events and personality

目的在中国汉族人群中探讨控制生活事件、人格的发病风险后,去甲肾上腺素转运体（NET）基因G1287A基因多态性与重性抑郁症（MD）的关联性。方法本研究采用年龄、性别1∶1配对病例对照研究设计。病例组为符合《精神疾病诊断与统计手册》第四版（DSM-Ⅳ）的重型抑郁障碍患者98例,并经汉密顿抑郁量表（HAMD）、抑郁自评量表（SDS）、遗传学研究用诊断检查（DIGS）筛查。对照组为来自同地区社会健康自愿人群98名。2组入组前均测试生活事件量表（LES）、艾森克个性问卷（EPQ）。基因多态性的实验测定使用焦磷酸测序仪PSCE96MA检测法。统计分析基因型、等位基因、EPQ个性纬度的相对危险度（OR）以及控制生活事件、人格对MD发病风险后的调整OR。结果 ①MD组G1287A基因AA基因型与A等位基因频率高于对照组。②G1287A各等位基因及基因型OR值也具梯度升高的趋势,但未达到统计学意义（P〉0.05）。③EPQ各纬度罹患MD风险的相对危险度OR及OR95%CI：危险变量EPQ-P为4.152（2.276,7.575）、EPQ-N为16.157（7.918,32.969）,保护变量EPQ-E为0.093（0.048,0.181）。④利用Logistic多元回归方程计算控制人格对MD的发病风险后的调整OR值,抑郁障碍CC等位基因调整OR升高（由2.907上升到4.478）外;其他等位基因和基因型的调整OR均下降（OR范围0.745~1.338）。结论在控制人格对MD的发病风险后,在中国汉族人群中只有CC基因型可能是MD的危险因素。

Objective To determine the correlation between norepinephrine transporter （NET） gene G1287A polymorphism and major depression （MD） under controlled life events and personality in Chinese Hans. Methods This was an ageand gender-matched （1∶1） case control study. 98 patients diagnosed as having MD based on DSM-IV were screened using Hamilton Depression （HAMD） scale, Self Depression Scale （SDS） and Diagnostic Interview for Genetic Studies （DIGS）. The 98 healthy community volunteers from identical district served as control group. All subjects were subjected to Life Event Scale （LES） and Eysenck Personality Questionnaire （EPQ） prior to enrollment. Laboratory test ing of gene polymorphism was undertaken via PSCE96MA measurement using pyrosequencing instrument. The odds ratios （OR） of genotypes, alleles and EPQ personality were analyzed, and adjusted ORs of controlled life event and personality on risks of MD were also assessed. Results MD group exhibited higher AA genotype and A allele frequency of G1287A gene than control group. Though statistically insignificant （P0.05）, each allele and genotype of G1287A gene showed evidence of gradual increase in their OR. The OR and 95% confidence interval of each EPQ dimension on incidence of MD were ordered as follows： the risk variant, EPQ-P, 4.152 （2.276, 7.575）; EPQ-N, 16.157 （7.918, 32.969）; and the protective variant, EPQ-E, 0.093 （0.048, 0.181）. Based on calculation of controlled personality on the risk of MD using Logistic multiple regression equation, all alleles and genotypes were found to have reduced adjusted OR （range： 0.745 to 1.338） with exception of allele CC in patients with depression showing an increased figure （2.907 ~ 4.478）. Conclusion CC genotype may be the single risk factor of MD in Chinese Hans as reflected by controlling personality.