Metabolic syndrome and insulin resistance in schizophrenia patients receiving antipsychotics genotyped for the methylenetetrahydrofolate reductase (MTHFR) 677C/T and 1298A/C variants
Metabolic syndrome and insulin resistance in schizophrenia patients receiving antipsychotics genotyped for the methylenetetrahydrofolate reductase (MTHFR) 677C/T and 1298A/C variants
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DOI：
10.1016/j.schres.2007.09.030
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发表时间：
2008-01-01
影响因子：
4.5
通讯作者：
Kerr, Jane
中科院分区：
文献类型：
--
作者：
Ellingrod, Vicki L.;Miller, Del D.;Kerr, Jane
简介：代谢综合征和胰岛素抵抗代表了与非典型抗精神病药（AAP）使用相关的越来越多的关注，因为其在精神分裂症人群中的发病率比普通人群高2 - 4倍。亚甲基四氢叶酸还原酶（MTHFR）活性降低，导致叶酸代谢异常和高同型半胱氨酸血症，已与心血管疾病相关，但与AAP相关的代谢并发症的关系尚未研究。目的：研究接受AAPs治疗≥ 12个月的精神分裂症患者MTHFR、代谢综合征和胰岛素抵抗之间的关系。方法：对58例受试者进行横断面分析，筛选代谢综合征、胰岛素抵抗和MTHFR 677C/T和1298A/C基因型。基因型组之间在年龄、性别、种族或AAP暴露方面没有差异。在677例T等位基因携带者中，53%符合代谢综合征标准，而CC基因型组为23%，OR = 3.7（95%CI = 1.24-12.66，p = 0.02）。因此，对于T等位基因受试者，风险几乎是四倍，尽管类似的抗精神病药物暴露。腰围和MTHFR基因型均能显著预测胰岛素抵抗（F = 8.35，df = 5，51，p
Introduction: The metabolic syndrome and insulin resistance represent growing concerns related to atypical antipsychotic (AAP) use as their incidence in the schizophrenia population is two-to-four-fold higher than the general population.Reduced methylenetetrahydrofolate reductase (MTHFR) activity, resulting in aberrant folate metabolism and hyperhomocysteinemia, has been linked to cardiovascular disease and is unstudied in relation to AAP associated metabolic complications.Purpose: To examine the relationship between MTHFR, metabolic syndrome, and insulin resistance in schizophrenia subjects receiving AAPs for >= 12 months.Methods: Fifty-eight subjects were included in this cross-sectional analysis and screened for the metabolic syndrome, insulin resistance and MTHFR 677C/T and 1298A/C genotype.Results: Overall, 23 subjects (40%) met metabolic syndrome criteria. There were no differences in age, gender, race, or AAP exposure between genotype groups. For the 677 T allele carriers, 53% met metabolic syndrome criteria, compared to 23% in the CC genotype group, giving an OR=3.7, (95% CI=1.24-12.66,p=0.02). Thus, for T allele subjects, the risk was almost four times greater, despite similar antipsychotic exposure. Both waist circumference and MTHFR genotype significantly predicted insulin resistance (F=8.35, df=5, 51, p