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抗精神病药物所致体重增加与多巴胺D2受体基因多态性和治疗效应无关联性
作者姓名:Zhang ZJ  Yao ZJ  Zhang XB  Chen JF  Sun J  Yao H  Hou G  Zhang XB
作者单位:南京医科大学附属脑科医院精神科,南京医科大学附属脑科医院精神科,南京医科大学附属脑科医院精神科,南京医科大学附属脑科医院精神科,南京医科大学附属脑科医院精神科,南京医科大学附属脑科医院精神科,南京医科大学附属脑科医院精神科,南京医科大学附属脑科医院精神科 南京 210029 中国,南京 210029 中国,南京 210029 中国,南京 210029 中国,南京 210029 中国,南京 210029 中国,南京 210029 中国,南京 210029 中国
基金项目:Project supported by the National Natural Science Foundation of China, № 30170344.
摘    要:目的:探讨抗精神病药物(APS)所致体重增加与多巴胺D2受体(DRD2)基因多态性和治疗效应之间有无相关性。方法:采用PCR-RFLP方法分析117例首发精神分裂症患者DRD2基因TaqI A多态性。APS治疗10周,测定患者治疗前后体重和体重指数(BMI),用阳性和阴性症状量表(PANSS)评定患者治疗前后精神症状,并分析基因型和PANSS减分率与BMI变化值的相关性。结果:治疗后患者平均体重增加(3±3)kg或基础体重的(6±6)%,体重变化的范围为-7 kg-12 kg或-7.8%-32.4%;患者年龄和基础BMI明显影响BMI变化值,差异有显著性(P=0.03,P=0.0001);DRD2基因TaqI多态性A1等位基因和PANSS减分率对BMI变化值的影响经检验差异均无显著性(均P>0.05)。结论:DRD2基因TaqI多态性不可能是APS所致体重增加的主要因素;体重增加不作为APS临床治疗效果的预测指标。

关 键 词:抗精神病药物  治疗效应  多巴胺D2受体  多态现象  体重增长  精神分裂症

No association of antipsychotic agent-induced weight gain with a DA receptor gene polymorphism and therapeutic response
Zhang ZJ,Yao ZJ,Zhang XB,Chen JF,Sun J,Yao H,Hou G,Zhang XB.No association of antipsychotic agent-induced weight gain with a DA receptor gene polymorphism and therapeutic response[J].Acta Pharmacologica Sinica,2003,24(3):235-240.
Authors:Zhang Zhi-Jun  Yao Zhi-Jian  Zhang Xiao-Bin  Chen Jian-Fang  Sun Jing  Yao Hui  Hou Gang  Zhang Xin-Bao
Institution:Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, 210029, China. LbiCheng@public1.ptt.js.cn
Abstract:AIM: To investigate whether there is an association of antipsychotic agent-induced weight gain with the TaqI A polymorphism of dopamine D2 receptor (DRD2) gene and therapeutic response to antipsychotic treatment in schizophrenia. METHODS: Genotyping was performed using the PCR-RFLP techniques in a total of 117 first-episode Chinese Han schizophrenic patients (mean age 26+/-8 a; 58 male, 59 female). Moreover, the measurements were finished either for baseline weight and body mass index (BMI) or for changed weight and BMI 10 weeks after antipsychotic treatment. The Positive and Negative Symptom Scale (PANSS) was used for the evaluation of the improvement of clinical psychotic symptoms. RESULTS: There was an average increase in body weight of (3+/-3) kg or (6+/-6) % of baseline weight with a changed range of -7 kg - 12 kg or -7.8 % - 32.4 % 10 weeks after treatment, and the change in the BMI was associated with the baseline BMI and patients' age (P=0.0001; P=0.03; respectively). However, there was no significant difference in distribution of allelic frequencies (X2=0.65, v1, P>0.05) and genotype (x2=1.47, v2, P>0.05) between the subgroups, and the change in BMI was not associated with genotypes of DRD2. Furthermore, there was no relationship of the therapeutic response to antipsychotic treatment with changed BMI in the patients (P>0.05). CONCLUSION: The TaqI A polymorphism of DRD2 gene is therefore unlikely to play an important role in antipsychotic agent-induced weight gain, a side effect of antipsychotic treatment. Furthermore, increase in body weight is unlikely to be prediction of therapeutic response to antipsychotic treatment in schizophrenia.
Keywords:dopamine D2 receptors  polymorphism(genetics)  antipsychotic agents  weight gain  schizophrenia
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