Delacrétaz Aurélie, Zdralovic Adna, Vandenberghe Frederik, Saigi-Morgui Nuria, Glatard Anaïs, Quteineh Lina, Gholam-Rezaee Mehdi, Raffoul Wassim, Applegate Lee Ann, Jafari Paris, Gamma Franziska, von Gunten Armin, Conus Philippe, Eap Chin B
Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
Centre of Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
Gene. 2017 Sep 10;628:8-15. doi: 10.1016/j.gene.2017.07.005. Epub 2017 Jul 8.
Genetic factors associated with Body Mass Index (BMI) have been widely studied over the last decade. We examined whether genetic variants previously associated with BMI in the general population are associated with cardiometabolic parameter worsening in the psychiatric population receiving psychotropic drugs, a high-risk group for metabolic disturbances. Classification And Regression Trees (CARTs) were used as a tool capable of describing hierarchical associations, to pinpoint genetic variants best predicting worsening of cardiometabolic parameters (i.e total, HDL and LDL-cholesterol, triglycerides, body mass index, waist circumference, fasting glucose, and blood pressure) following prescription of psychotropic drugs inducing weight gain in a discovery sample of 357 Caucasian patients. Significant findings were tested for replication in a second Caucasian psychiatric sample (n=140). SH2B1 rs3888190C>A was significantly associated with LDL levels in the discovery and in the replication sample, with A-allele carriers having 0.2mmol/l (p=0.005) and 0.36mmol/l (p=0.007) higher LDL levels compared to others, respectively. G-allele carriers of RABEP1 rs1000940A>G had lower fasting glucose levels compared to others in both samples (-0.16mmol/l; p<0.001 and -0.77mmol/l; p=0.03 respectively). The present study is the first to observe such associations in human subjects, which may in part be explained by a high risk towards dyslipidemia and diabetes in psychiatric patients receiving psychotropic treatments compared to population-based individuals. These results may therefore give new insight into the etiology of LDL-cholesterol and glucose regulation in psychiatric patients under psychotropic drug therapy.
在过去十年中,与体重指数(BMI)相关的遗传因素得到了广泛研究。我们研究了先前在普通人群中与BMI相关的基因变异,是否与接受精神药物治疗的精神疾病患者的心脏代谢参数恶化有关,这是一个代谢紊乱的高危群体。分类回归树(CART)被用作一种能够描述分层关联的工具,以确定在357名白种人患者的发现样本中,在使用导致体重增加的精神药物后,最能预测心脏代谢参数恶化(即总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇、甘油三酯、体重指数、腰围、空腹血糖和血压)的基因变异。在第二个白种人精神疾病样本(n=140)中对显著发现进行了重复测试。SH2B1 rs3888190C>A在发现样本和重复样本中均与低密度脂蛋白水平显著相关,A等位基因携带者的低密度脂蛋白水平分别比其他人高0.2mmol/l(p=0.005)和0.36mmol/l(p=0.007)。在两个样本中,RABEP1 rs1000940A>G的G等位基因携带者的空腹血糖水平均低于其他人(分别为-0.16mmol/l;p<0.001和-0.77mmol/l;p=0.03)。本研究首次在人类受试者中观察到这种关联,这可能部分是由于与基于人群的个体相比,接受精神药物治疗的精神疾病患者患血脂异常和糖尿病的风险较高。因此,这些结果可能为接受精神药物治疗的精神疾病患者低密度脂蛋白胆固醇和血糖调节的病因学提供新的见解。