不同亚型神经性厌食患者的冲动特质及其与5-羟色胺转运体基因连锁多态区多态性的关联研究

Impulsive trait of patients with different subtypes of anorexia nervosa and its association with 5-hydroxytryptamine transporter gene-linked polymorphic region polymorphism

目的·探究不同亚型神经性厌食(anorexia nervosa,AN)患者的冲动特质及其与5-羟色胺转运体基因连锁多态区(5-hydroxytryptamine transporter gene-linked polymorphic region,5-HTTLPR)多态性之间的关系。方法·选择2013年7月—2018年7月期间于上海交通大学医学院附属精神卫生中心临床心身病房及心理咨询门诊治疗的AN患者,其中限制型(restricting type)患者(AN-R组)76例、暴食清除型(binge/purging type)患者(AN-BP组)81例。分别采用一般情况调查表、进食障碍检查自评问卷6.0(Eating Disorder Examination Questionnaire 6.0,EDE-Q 6.0)和Barratt冲动性量表第11版(Barratt Impulsiveness Scale 11th Version,BIS-11)对2组患者的一般情况、临床特征及冲动特质进行分析。采用实时荧光定量PCR检测2组患者的5-HTTLPR多态性位点,并进行基因分型。结果·与AN-R组相比,AN-BP组患者的EDE-Q 6.0总分及其4个分量表得分、BIS-11总分及其3个维度得分均有所增加(均P<0.05),但2组患者的5-HTTLPR基因型及等位基因频率分布间差异均无统计学意义。同时,携带3种5-HTTLPR基因型(S/S、S/L和L/L)的AN患者的BIS-11总分及3个维度得分间差异亦均无统计学意义。结论·AN-BP患者较AN-R患者具有更明显的冲动特征,但未发现2种疾病亚型或冲动特质与5-HTTLPR多态性存在相关性。

Objective·To explore the impulsive trait of patients with different subtypes of anorexia nervosa(AN)and its relationship with 5-hydroxytryptamine transporter gene-linked polymorphic region(5-HTTLPR)polymorphism.Methods·The patients with AN treated in the Clinical Psychosomatic Ward and Psychological Counseling Clinic of Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine from July 2013 to July 2018 were selected,including 76 patients with restricting type(AN-R group)and 81 patients with binge/pursing type(AN-BP group).The general situations,clinical characteristics and impulsive traits of the two groups were analyzed by General Situation Questionnaire,Eating Disorder Examination Questionnaire 6.0(EDE-Q 6.0)and Barratt Impulsivity Scale 11th Version(BIS-11),respectively.Quantitative real-time PCR was used to detect the 5-HTTLPR polymorphism of the two groups,and genotyping was performed.Results·Compared with AN-R group,the total score of EDE-Q 6.0 and its four subscales,the total score of BIS-11 and its three dimensions in AN-BP group were increased(all P<0.05).However,there was no significant difference in the distribution of 5-HTTLPR genotype and allele frequencies between the two groups.At the same time,there was no significant difference in the total score of BIS-11 and its three dimensions among AN patients with three 5-HTTLPR genotypes(S/S,S/L,L/L).Conclusion·AN-BP patients have more obviously impulsive traits than AN-R patients,but there is no correlation between two disease subtypes or impulsive traits and 5-HTTLPT polymorphism.