Bönsch Dominikus, Bayerlein Kristina, Reulbach Udo, Fiszer Roland, Hillemacher Thomas, Sperling Wolfgang, Kornhuber Johannes, Bleich Stefan
Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6 91054 Erlangen, Germany.
Alcohol Alcohol. 2006 Jul-Aug;41(4):364-7. doi: 10.1093/alcalc/agl024. Epub 2006 Apr 20.
The typology by Lesch distinguishes between four subtypes: type 1 (model of allergy), type 2 (model of anxiety or conflict), type 3 (alcohol as an antidepressant), and type 4 (alcohol as adaptation). Taking into account that alcohol dependence is associated with elevated homocysteine levels, this study was undertaken to investigate different MTHFR (methylenetetrahydrofolate reductase) genotypes related to homocysteine metabolism in patients with alcohol dependence who were classified according to Lesch's typology (LT).
134 non-abstinent chronic alcoholics (112 males, 22 females; mean age 44.2 (SD 8.9) years) were classified according to LT and divided into four groups: LT 1 (n = 26), LT 2 (n = 65), LT 3 (n = 58), and LT 4 (n = 18). Total plasma homocysteine levels and MTHFR genotypes -393, 677, and 1,793 were determined.
We observed a significantly higher frequency of the thermolabile MTHFR 677 C-->T variant (TT) in patients classified as subtype LT4 when compared with subtypes LT2 and LT3 (P = 0.005). Furthermore, for the MTHFR -393 C --> A-polymorphism, significantly more AC/AA variants were found in subtype LT4 (P = 0.034). No differences in allele-distribution were detected for MTHFR 1793.
To our knowledge, this is the first study evaluating MTHFR genotypes in patients who were classified according to LT. Significantly different distributions of MTHFR 677 and -393 variants within Lesch Type 4 as compared with Types 2 and 3 hint at genetic determination of Lesch subtypes.
莱施（Lesch）的分类法区分了四种亚型：1型（过敏模型）、2型（焦虑或冲突模型）、3型（酒精作为抗抑郁药）和4型（酒精作为适应方式）。鉴于酒精依赖与高半胱氨酸水平升高有关，本研究旨在调查根据莱施分类法（LT）分类的酒精依赖患者中与高半胱氨酸代谢相关的不同亚甲基四氢叶酸还原酶（MTHFR）基因型。
134名未戒酒的慢性酒精中毒者（112名男性，22名女性；平均年龄44.2（标准差8.9）岁）根据LT进行分类，并分为四组：LT1组（n = 26）、LT2组（n = 65）、LT3组（n = 58）和LT4组（n = 18）。测定了血浆总高半胱氨酸水平以及MTHFR基因型-393、677和1793。
我们观察到，与LT2和LT3亚型相比，被分类为LT4亚型的患者中，不耐热的MTHFR 677 C→T变异体（TT）的频率显著更高（P = 0.005）。此外，对于MTHFR -393 C→A多态性，在LT4亚型中发现的AC/AA变异体明显更多（P = 0.034）。未检测到MTHFR 1793等位基因分布的差异。
据我们所知，这是第一项评估根据LT分类的患者中MTHFR基因型的研究。与2型和3型相比，莱施4型中MTHFR 677和-393变异体的分布存在显著差异，这表明莱施亚型存在遗传决定性。
