脂联素基因多态性在抗精神病药对糖脂代谢影响中的意义

目的了解精神分裂症患者的脂联素基因外显子2T45G多态性，并探讨其与应用非典型抗精神病药治疗相关的肥胖以及糖代谢的关系。方法入组患者组125例为应用非典型抗精神病药的精神分裂症患者，正常对照组59例。提取两组基因组DNA，采用聚合酶链式反应-限制片段长度多态性技术，检测脂联素（Adi）基因外显子2T45G多态性和等位基因分布频率。采用免疫酶吸附（ELISA）法分别测定两组血脂，空腹血糖、胰岛素水平计算胰岛素抵抗指数（HOMA-IR），测量身高、体质量，计算体质量指数（BMI），并将两组对照比较。结果使用抗精神病药的患者与正常对照组之间脂联素基因型分布及等位基因频率均差异无显著性（χ^2=0．723，0．257；P=0．697，0．613）。携带TG／GG基因型患者的BMI显著高于携带TT型患者（23．53±2．77vs22．37±3．11，P〈0．05），且携带TG／GG型患者低密度脂蛋白（LDL—C）水平显著高于携带，TT型患者（2．67±0．85vs2．28±1．15，P〈0．05）。携带TT和TG／GG型基因的患者之间的胰岛素抵抗及血脂其他各项差异均无显著性（P〉0．05）；多元线性回归分析示Adi基因外显子2T45G多态性与HOMA—IR并不相关。结论Adi基因外显子2T45G多态性与非典型抗精神病药物治疗相关的脂代谢异常相关，但不是影响血糖代谢障碍的基因危险因子。

Impact of polymorphisms of adiponectin gene on antipsychotics-related lipid and glucose metabolic disturbances

Objective To investigate the polymorphisms of T45G in adiponectin gene 2 in schizophrenic inpatients and its impacts on obesity and glucose metabolism associated with atypical antipsyehotics use. Methods 125 schizophrenic inpatients with atypical antipsychotics and 59 normal people were involved in the study, adiponectin gene T45G polymorphisms and allele were determined with the polymerase chain reaction and restricted fragment length polymorphism assay. Serum leptin and insulin were measured with ELISA,then calculate homeostasis model assesment（ HOMA- IR） and BMI. Results The differences of adiponeetin genotypes and allele distribution between schizophrenic patients with antipsychoties and normal group were not found （χ^2 =0. 723,0. 257;P = 0. 697,0. 613 ）, BMI in genotype TG/GG patients were significantly higher than that in genotype TT（23.53±2.77vs22. 37±3.11, P 〈 0. 05 ）, and the serum cholesterol level in genotype TG/GG patients were significantly higher than that in genotype TT（ 2. 67±0. 85vs2. 28±1.15, P 〈 0. 05 ）, but there were no difcrenee in HOMA - IR and other serum cholesterol levels between these two groups（ P 〉 0. 05 ）. Multiple linear regression analysis suggested polymorphisms of adiponeetin gene T45G did not entry the equation that influenced HOMA - IR. Conclusions The polymorphisms of adiponectin gene T45G were associations with antipsyehoties - related lipid metabolic disturbances, and it had not been considered as a gene predictors that influenced glucose metabolism.