Bellivier F
Department of Psychiatry, CHU Henri-Mondor, 94010 Créteil cedex, France.
Eur Psychiatry. 2005 Dec;20 Suppl 4:S335-9. doi: 10.1016/s0924-9338(05)80187-7.
The relatively high comorbidity of type 2 diabetes and schizophrenia may suggest a shared biological susceptibility to these two conditions. Family studies have demonstrated an increased risk of diabetes in unaffected relatives of patients with schizophrenia, consistent with a heritable susceptibility trait. Linkage analyses have identified several loci that are associated with schizophrenia and some of these, notably those on chromosomes 2p22.1-p13.2 and 6g21-824.1 have also been observed in linkage studies in type 2 diabetes. In addition, the dopamine D5 receptor on chromosome 5 and the tyrosine hydroxylase gene on chromosome 11 have both been suggested as candidate genes in schizophrenia and may also be implicated in susceptibility to poor glycaemic control. In addition, an increased rate of type II diabetes has been observed in some patients treated with antipsychotics. Potential neurochemical substrates of this effect include the histamine H1 receptor, the 5-HT2C serotonin receptor or the beta3 adrenoreceptor. However, the search for a genetic basis to the association between diabetes and schizophrenia is still in its infancy, and much further work needs to be performed, including the systematic screening of all confirmed susceptibility loci and quantitative trait locus mapping of glycaemic control.
2型糖尿病与精神分裂症较高的共病率可能表明这两种疾病存在共同的生物学易感性。家族研究表明，精神分裂症患者未患病的亲属患糖尿病的风险增加，这与遗传易感性特征一致。连锁分析已经确定了几个与精神分裂症相关的基因座，其中一些，特别是位于2号染色体p22.1-p13.2和6号染色体g21-824.1上的基因座，在2型糖尿病的连锁研究中也有观察到。此外，5号染色体上的多巴胺D5受体和11号染色体上的酪氨酸羟化酶基因都被认为是精神分裂症的候选基因，也可能与血糖控制不佳的易感性有关。此外，在一些接受抗精神病药物治疗的患者中观察到II型糖尿病的发病率增加。这种效应的潜在神经化学底物包括组胺H1受体、5-羟色胺2C血清素受体或β3肾上腺素能受体。然而，寻找糖尿病与精神分裂症之间关联的遗传基础仍处于起步阶段，还需要进行更多的工作，包括对所有已确认的易感基因座进行系统筛查以及对血糖控制进行数量性状基因座定位。
