Kovacic Petrovic Zrnka, Nedic Erjavec Gordana, Nikolac Perkovic Matea, Svob Strac Dubravka, Peraica Tina, Tudor Lucija, Pivac Nela
School of Medicine, University of Zagreb, Zagreb, Croatia.
Psychiatr Danub. 2019 Mar;31(1):78-87. doi: 10.24869/psyd.2019.78.
The role of serotonin transporter and its functional gene polymorphism (5-HTTLPR, serotonin transporter linked polymorphic region) was investigated in sleep disturbances in various mental disorders, with conflicting findings. Here, the association of particular sleep disturbances with 5-HTTLPR genotypes and platelet serotonin (5-HT) concentration was determined simultaneously in veterans with posttraumatic stress disorder (PTSD), who were subdivided into those with or without comorbid depression.
Croatian male, medication-free war veterans with PTSD (N=325), subdivided into those with or without comorbid depression, and subdivided further according to the various sleep disturbances, were evaluated using the Structured Clinical Interview, the Hamilton Rating Scale for Depression and the Clinician Administered PTSD Scale. Genotyping and platelet 5-HT concentration measurements were conducted using PCR and spectrofluorimetric methods, respectively.
Nominally higher frequency of the 5-HTTLPR LL genotype compared to S carriers (p=0.026; χ test) and significantly higher platelet 5-HT concentration (p=0.001; one-way ANOVA) were detected in non-depressed veterans with PTSD with early insomnia, compared to matched veterans without early insomnia.
Over-representation of the LL genotype of the 5-HTTLPR and higher platelet 5-HT concentrations were detected in veterans with PTSD who did not develop comorbid depression but had severe early insomnia. These results suggest that 5-HTTLPR genotypes and platelet 5-HT concentration are associated with early insomnia in non-depressed veterans with PTSD. Limitations of the study were the cross-sectional nature of the study, biallelic assessment of the 5-HTTLPR, and a lack of use of the specific sleep measurement scales. These results should be replicated in larger samples, validated on different populations, using specific sleep measurement scales and triallelic 5-HTTLPR assessment.
血清素转运体及其功能基因多态性（5-HTTLPR，血清素转运体连锁多态性区域）在各种精神障碍的睡眠障碍中的作用已得到研究，但结果相互矛盾。在此，我们同时确定了创伤后应激障碍（PTSD）退伍军人中特定睡眠障碍与5-HTTLPR基因型和血小板血清素（5-HT）浓度之间的关联，这些退伍军人被分为有或没有共病抑郁症的两组。
对325名克罗地亚男性、未服用药物的PTSD退伍军人进行评估，这些退伍军人被分为有或没有共病抑郁症的两组，并根据各种睡眠障碍进一步细分，评估采用结构化临床访谈、汉密尔顿抑郁评定量表和临床医生管理的PTSD量表。分别使用PCR和荧光分光光度法进行基因分型和血小板5-HT浓度测量。
与无早期失眠的匹配退伍军人相比，患有早期失眠的非抑郁PTSD退伍军人中，5-HTTLPR LL基因型的频率名义上高于S等位基因携带者（p = 0.026；χ检验），且血小板5-HT浓度显著更高（p = 0.001；单因素方差分析）。
在未发生共病抑郁症但患有严重早期失眠的PTSD退伍军人中，检测到5-HTTLPR的LL基因型过度表达和较高的血小板5-HT浓度。这些结果表明，5-HTTLPR基因型和血小板5-HT浓度与非抑郁PTSD退伍军人的早期失眠有关。本研究的局限性在于研究的横断面性质、5-HTTLPR的双等位基因评估以及缺乏使用特定的睡眠测量量表。这些结果应在更大的样本中重复验证，在不同人群中进行验证，使用特定的睡眠测量量表和5-HTTLPR的三等位基因评估。
