Taherianfard M, Shariaty M
Ebne Sina Hospital, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
Indian J Med Sci. 2004 Jan;58(1):3-9.
Recent studies have implicated the abnormalities in the gamma-aminobutyric acid (GABA) neurotransmmiter system in the pathophysiology of schizophrenia. There are also evidences indicating that steroids of central or peripheral origin may modulate GABAergic system through direct interaction with the GABAA receptor complex. These raise the possibility that alternations in serum steroid hormones may contribute to the pathophysiological process in the schizophrenia.
The purposes of this study were first, to determine whether alternations in steroid serum levels occur in schizophrenic patients, and secondly to determine whether such alternations normalize with clinical improvement.
Serum concentrations of testosterone (T), estradiol (E), progesterone (P) and cortisol (C) were determined in male schizophrenic patients (N = 49) before treatment, during treatment and after recovery and in age-matched healthy male subjects (N = 17). All steroid hormones were assayed by ELISA method.
Differences in steroids concentrations between groups were assayed by One-Way Analysis of Variance (ANOVA), followed by Tukey's post hoc test. The level of significance was considered at P < 0.05.
The serum concentrations of E, P and C were significantly (P < 0.05) lower in male schizophrenic patients in all three stages of the study, compared with healthy subjects. Serum concentrations of T were significantly (P < 0.05) lower in male schizophrenic patients before and during treatment, but not after recovery, compared with healthy subjects. These findings support the occurrence of abnormal steroid concentrations in schizophrenic patients and suggest that lower T level in this disorder is related to the illness and normalizes with remission, while trait-related factors may contribute to lower serum E and C levels in schizophrenia.
近期研究表明，γ-氨基丁酸（GABA）神经递质系统异常与精神分裂症的病理生理学有关。也有证据表明，中枢或外周来源的类固醇可能通过与GABAA受体复合物直接相互作用来调节GABA能系统。这增加了血清类固醇激素变化可能参与精神分裂症病理生理过程的可能性。
本研究的目的一是确定精神分裂症患者血清类固醇水平是否发生变化，二是确定这些变化是否会随着临床症状的改善而恢复正常。
测定了49例男性精神分裂症患者治疗前、治疗期间和康复后的血清睾酮（T）、雌二醇（E）、孕酮（P）和皮质醇（C）浓度，并与17例年龄匹配的健康男性受试者进行了比较。所有类固醇激素均采用酶联免疫吸附测定（ELISA）法检测。
采用单因素方差分析（ANOVA）对各组类固醇浓度差异进行分析，随后进行Tukey事后检验。显著性水平设定为P < 0.05。
在研究的所有三个阶段，男性精神分裂症患者的血清E、P和C浓度均显著低于健康受试者（P < 0.05）。与健康受试者相比，男性精神分裂症患者治疗前和治疗期间的血清T浓度显著降低（P < 0.05），但康复后无显著差异。这些发现支持精神分裂症患者存在类固醇浓度异常，提示该疾病中较低的T水平与疾病有关，且随着病情缓解而恢复正常，而特质相关因素可能导致精神分裂症患者血清E和C水平较低。
