DRD2、HTR2A和HTR2C基因在氯氮平诱导代谢综合征发生中的作用

目的探讨多巴胺D2受体（DRD2）、5-羟色胺2A受体（HTR2A）及5-羟色胺2c受体（HTR2C）基因在氯氮平诱导代谢综合征（MS）发生过程中的作用。方法根据美国国家胆固醇教育项目成人治疗组第三次指南（NCEP—ATPⅢ）的诊断标准，将199例长期服用氯氮平的精神分裂症患者分为MS组和非MS组，选取DRD2、HTR2A及HTR2C功能单核苷酸多态性（SNP）位点rs1800497、rs6311和rsl414334，采用SNaPshotSNP基因分型技术对所有患者进行检验，并测定患者空腹血糖（FPG）、三酰甘油（TG）、高密度脂蛋白（HDL）等生化指标。结果两组体质量指数、腰围、FPG、TG、HDL、收缩压及舒张压比较差异均有统计学意义（P〈0．05）。两组SNP位点基因型及等位基因频率分布的差异无统计学差异（P〉0．05）。rsl800497不同基因型携带者FPG比较差异有统计学意义（F=3．4，P=0．036），其中T／T基因型携带者FPG水平显著高于C／T携带者（P=0．011）。结论DRD2基因rsl800497可能不是氯氮平诱导MS的直接作用位点，但可能通过影响DRD2表达，造成患者体内糖代谢异常，增加MS的发生风险。

Effects of DRD2, HTR2A,and HTR2C genes on process of metabolic syndrome induced by clozapine

Objective To investigate the effects of dopamine D2 receptor （DRD2）, 5-serotonin 2A receptor （HTR2A）, and 5-serotonin 2C receptor （HTR2C） genes on the process of metabolic syndrome （MS） induced by clozapine. Methods According to the diagnostic criteria of National Cholesterol Education Program＇s Adult Treatment Panel Ⅲ （NCEP-ATP Ⅲ）, 199 schizophrenic patients with long-term use of clozapine were divided into MS group and non-MS group. The polymorphisms of DRD2, HTR2A, and HTR2C （rs1800497, rs6311 and rs1414334, respectively） were genotyped by the SNaPshot SNP and the serum levels of fasting plasma glucose （FPG）, triglyceride （TG）, and high density fipoprotein cholesterol （HDL） were measured. Results The differences of body mass index, levels of waist circumference, FPG, TG, HDL, and blood pressure of two groups were statistically significant （P〈0.05） . The differences of allele and genotype frequencies of SNPs of two groups were not statistically significant （ P 〉 0.05）. The differences of FPG levels of patients with differentgenotypes of rs1800497 were statistically significant （F=3.4, P=0. 036） and the FPG levels of patients with T/ T genotype were significantly higher than those of patients with C/T genotype （P=0.011）. Conclusion The rs1800497 of DRD2 may not be the direct-causing polymorphism of clozapine induced MS. But it may affect the expression of DRD2, cause the abnormal glucose metabolism, and then increase the risk for MS.