目的探讨抗精神病药长程治疗对女性精神分裂症患者生殖激素、骨密度和体质量的影响及其相互关系。方法 80例年龄在18-44周岁的首发女性精神分裂症患者用随机数字变法随机分为利培酮和奎硫平治疗组,每组各40例,进行为期12个月的研究,于治疗前、治疗后第6、12月末测定体重、身高并计算体重指数(body mass index BMI),测定血清促卵泡激素、黄体生成素、雌二醇、孕酮、孕酮、催乳素6种生殖激素浓度,用双能X线骨密度仪(dualenergyX-rayabsorptiometryDEXA)测量腰椎(L2-L4)和左侧股骨颈3个位点的骨密度定。结果 (1)利培酮组有31人,奎硫平组有33人完成研究。(2)治疗12月末,利培酮组腰椎骨密度低于治疗前(t=2.35、P=0.025),治疗后6、12月末,催乳素浓度(F=68.372、P=0.000;F=58.520、P=0.000))、体质量(F=5.261、P=0.029;F=5.973、P=0.019)高于治疗前,雌二醇(F=14.532、P=0.009;F=17.421、P=0.003)和孕酮(F=7.454、P=0.026、F=9.573、P=0.036)低于治疗前,差异有统计学意义;奎硫平组治疗后6、12月末体质量(F=6.274、P=0.019;F=9.238、P=0.009)高于治疗前,差异有统计学意义。(3)治疗第12周末,利培酮组腰椎骨密度变化率与催乳素变化率呈负相关(r=-0.62、P=0.023),和雌二醇变化率正相关(r=0.46、P=0.044),和体重指数变化率呈正相关(r=0.58、P=0.035),与孕酮变化率不相关(r=0.26、P=0.091)。结论利培酮治疗过程中伴有骨密度下降、催乳素升高和体质量增加,且骨密度变化与催乳素变化率呈负相关,与体质量、雌二醇变化率正相关。
Background: In several previous biochemical and genetic studies, the Val158Met polymorphism of the gene encoding catechol-O-methyltransferase (COMT) and the C677T polymorphism of Methylenetetrahydrofolate reductase (M...
详细信息
Background: In several previous biochemical and genetic studies, the Val158Met polymorphism of the gene encoding catechol-O-methyltransferase (COMT) and the C677T polymorphism of Methylenetetrahydrofolate reductase (MTHFR) have been suggested to be involved in the pathogenesis as well as the treatment response of major depressive disorder (MDD), but the results have been inconsistent. In this study, we investigate the association of COMT/MTHFR and their interactions with MDD and antidepressant response in Chinese Han population. Methods: Three hundred and sixty eight depressed patients who met DSM-Ⅳ criteria for MDD were recruited for the study. Two hundred and nineteen normal controls were recruited from local community. Patients and normal controls were genotyped for the functional COMT val158met and MTHFR C677T polymorphisms. Patients were characterized for clinical response to antidepressant treatment as measured by intra-individual changes of Hamilton Depression (HAMD-17) scores over 6 weeks. Results: The T allele (OR=1.81;95%CI=1.40-2.34, P<0.001) and C/T genotype (OR=3.66;95%CI =2.53-5.28, P<0.001) of MTHFR C677T were significantly different between case and control group. The COMT Met/Val genotype was more common among depressed individuals than among controls (OR=1.52, CI95%=1.04-2.21, P=0.02). Limitation: There is disequilibrium in age and sex between case and control group. Though we control the two variables in the statistic analysis, to be more accurate, we need to increase sample size in further study. Conclusion: Individuals with the genotype COMT Met/Val and MTHFR C/T have more probability to suffer from MDD. However, there is no association between gene polymorphism and treatment response.
暂无评论