首发精神分裂症代谢综合征的评估及其与瘦素、5-HTR2C基因的关联研究

发布时间：2018-03-23 01:09

本文选题：精神分裂症　切入点：代谢综合征　出处：《中南大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的： 1.评估首发未服药的精神分裂症患者和正常对照的各项代谢综合征相关指标,并比较二者间是否存在差异； 2.探讨瘦素基因启动子区2548G/A及5-HTR2C基因759C/T两个位点的多态性在首发精神分裂症和正常对照之间是否存在差异,以及是否与代谢综合征有关。方法： 1.临床研究部分：共入组首发未服药的精神分裂症患者100例,正常对照组118例。测量受试者的以下指标：血压、腰围、臀围、身高、血糖、体重、血脂、OGTT2h血糖、空腹胰岛素；计算体质量(BMI)、腰臀比(WHR)及胰岛素抵抗指数(IRI)。 2.基因多态性研究部分：采用基质辅助激光解吸/电离飞行时间质谱(MALDI-TOFMS)方法,对精神分裂症患者137例,正常对照组165例进行2548G/A及759C/T两个位点进行基因分析。结果： 1.首发未服药的精神分裂症患者组代谢综合征的发生率为6%,显著高于对照组的0.83%。 2.首发患者组的空腹血糖受损(IFG)、糖耐量降低(IGT)、糖尿病(DM)、糖代谢异常的发病率分别为4%、11%、7%、22%,显著高于对照组(分别为0%、2.54%、0%、2.54%)。首发患者组的空腹血糖(4.75±0.74)、糖负荷后2小时血糖(6.50±1.79)、IRI(1.86±2.359)均显著高于对照组(4.18±0.55,4.98±1.31,1.25±0.784)。 3.首发患者组的高密度脂蛋白(HDL-C)(1.31±0.32)显著低于对照组(1.50土0.30)。 4.瘦素基因启动子区2548G/A及5-HTR2C基因759C/T两个位点的基因型及等位基因频率在两组间无差异,且不同基因型间的糖、脂代谢指标亦无显著性差异。结论： 1.首发未服药的精神分裂症中代谢综合征发生率增高,二者之间可能存在共病的倾向。 2.首发未服药的精神分裂症患者中存在糖代谢的异常和HDL-C的降低。 3.未能证实瘦素基因和5-HT2C基因可能是精神分裂症的易感基因；瘦素基因-2548G/A位点和5-HT2C基因-759C/T可能对糖脂代谢无影响。
[Abstract]:Objective:. 1. To evaluate the related indexes of metabolic syndrome between the first-episode patients with schizophrenia and the normal controls, and to compare whether there are differences between the two groups. 2. To investigate whether the polymorphism of 2548G/A and 5-HTR2C 759C/T in leptin promoter region is different between first-episode schizophrenia and normal control, and whether it is related to metabolic syndrome. Methods:. 1. Clinical study: 100 patients with schizophrenia and 118 normal controls were enrolled in the study. The following parameters were measured: blood pressure, waist circumference, hip circumference, height, blood glucose, weight, blood lipids, OGTT 2h blood glucose, fasting insulin; The body mass, waist to hip ratio (WHR) and insulin resistance index (IRI) were calculated. 2. Gene polymorphisms were studied by matrix assisted laser desorption / ionization time of flight mass spectrometry (MALDI-TOFMS) in 137 patients with schizophrenia and 165 normal controls. The 2548G/A and 759C/T loci were analyzed. Results:. 1. The incidence of metabolic syndrome in schizophrenic group was significantly higher than that in control group. 2. The incidence of impaired fasting blood glucose (IFG), impaired glucose tolerance (IGT), diabetes mellitus (DMN), and abnormal glucose metabolism in the first patient group were 41111 and 77.22%, respectively, which were significantly higher than those in the control group (0 ~ 2.54). The fasting blood glucose of the first patient group was 4.75 卤0.74, and the blood glucose of 2 hours after glucose load was 6.50 卤1.79 IRI _ (1.86 卤2.359). It was significantly higher than that in the control group (4.18 卤0.55U, 4.98 卤1.31g, 1.25 卤0.784). 3. The HDL-C of the first-episode group was significantly lower than that of the control group (1.50 卤0.32 卤1.31 卤0.32). 4. The genotype and allele frequencies of 2548G/A and 5-HTR2C 759C/T in leptin promoter region were not different between the two groups, and there was no significant difference in glucose and lipid metabolism between the two groups. Conclusion:. 1. The incidence of metabolic syndrome in first-episode schizophrenia was increased, and there may be a tendency to co-develop between the two. 2. Abnormal glucose metabolism and decreased HDL-C were found in patients with schizophrenia. 3. Leptin gene and 5-HT2C gene may be susceptible to schizophrenia, but leptin gene -2548 G / A locus and 5-HT2C gene -759C / T may have no effect on glucose and lipid metabolism.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.3

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