瘦素及ghrelin基因多态性与精神分裂症患者利培酮所致代谢变化的关系

Relationship of leptin and ghrelin gene polymorphisms with metabolic changes induced by risperidone in patients with schizophrenia

目的探讨精神分裂症受试使用利培酮治疗后体质量、代谢相关指标的改变,并分析瘦素基因-2548G/A多态性,ghrelin基因Leu72Met多态性和体质量及代谢相关指标变化间的联系。方法68例精神分裂症患者利培酮单药治疗10周,入组,收集治疗4周和10周时的相关代谢指标体质指数(BMI)、腰围、空腹血糖和血脂指标水平。聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术检测瘦素基因和ghrelin基因多态性。结果治疗期间体质量、血糖和血脂指标均升高,差异有统计学意义(P<0.05)。ghrelin基因Leu72Met多态性和血糖变化相关(F=4.269,P=0.042),Leu72等位基因携带者空腹血糖水平较高。瘦素基因多态性和2种基因多态性均与体质量和代谢指标变化无关(P>0.05)。结论利培酮急性期治疗过程中,患者可以出现不同程度的体质量指标、血糖和血脂水平的升高。ghrelin基因Leu72等位基因可能是使用利培酮治疗的精神分裂症患者发生高血糖的危险因素。

Objective To investigate the changes of body weight and metabolism related indexes after risperidone treatment in schizophrenia and to analyze the relationship of leptin gene 2548G/A polymorphism and polymorphism of ghrelin gene leucine 72 methionine(Leu72Met)with changes in body weight and metabolism related indicators.Methods Sixty-eight patients with schizophrenia were treated with risperidone monotherapy for 10 weeks.The metabolic indexes including body mass index(BMI),waist circumference,fasting blood glucose and blood lipid levels were measured at 4 and 10 weeks after treatment.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)technique was used to detect the polymorphisms of leptin gene and ghrelin gene.Results The patients'body weight,blood glucose and blood lipids were significantly increased during treatment(P<0.05).The ghrelin gene Leu72Met polymorphism was associated with changes in blood glucose(F=4.269,P=0.042),and the Leu72 allele carrier had a higher fasting blood glucose level.The polymorphisms of leptin gene and two genes were not related to changes in body weight or metabolic indexes(P>0.05).Conclusion During the acute phase of risperidone treatment,patients may have different levels of body weight,blood glucose and blood lipid.The ghrelin gene Leu72 allele may be a risk factor for hyperglycemia in patients with schizophrenia treated with risperidone.