瘦素基因 rs7799039 调节汉族青少年地震后创伤后应激障碍的发生率。
The Leptin Gene rs7799039 Modulates the Prevalence of Posttraumatic Stress Disorder After an Earthquake in Han Chinese Adolescents.
机构信息
Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China.
Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University. Address: 17 Section 3, S Renmin Rd, Chengdu 610041 P. R. China.
出版信息
J Clin Psychiatry. 2019 Dec 24;81(1):18m12706. doi: 10.4088/JCP.18m12706.
OBJECTIVES
The study's aim was to examine the prevalence and severity of posttraumatic stress disorder (PTSD) longitudinally among high school students with different genotypes of the leptin gene (LEP) rs7799039 after the 2008 Wenchuan earthquake in China.
METHODS
The symptoms of PTSD were measured by the PTSD Checklist-Civilian Version (PCL-C) based on DSM-IV-TR criteria in 462 students at 6, 12, and 18 months after the earthquake. The genotypes of LEP rs7799039 were identified by polymerase chain reaction-restriction fragment length polymorphism analyses in 2018 using genomic DNA prepared in 2008 and stored at -80°C and verified by DNA sequencing. The association of LEP genotypes with PTSD was then analyzed by various statistical methods.
RESULTS
The AA homozygotes had higher prevalence of PTSD than the G allele carriers at 12 months (22.30% vs 10.53%, P = .013) and higher median (interquartile range [IQR]) PCL-C scores at 12 (27.00 [24.00-35.75] vs 26.00 [22.00-31.25], P = .010) and 18 months (27.00 [21.00-32.00] vs 24.00 [19.00-29.00], P = .003) post-earthquake among female subjects. Female students had higher PCL-C scores than male subjects at 6 and 12 months regardless of the genotypes but only among the AA homozygotes at 18 months (27.00 [21.00-32.00] vs 22.00 [18.00-26.00], P = .000). The potential risk factors for and predictors of PTSD severity differed at different time points during follow-up. LEP rs7799039 was a potential factor for PTSD at 12 months and a predictor of PTSD severity at 18 months post-earthquake.
CONCLUSIONS
An association of LEP rs7799039 with the prevalence and severity of PTSD in Chinese adolescents was observed. These results indicate that females with the LEP rs7799039 AA genotype had more severe PTSD characteristics compared to female G allele carriers, suggesting that psychosocial or pharmacologic managements may particularly be needed by these female subjects.
目的
本研究旨在探讨 2008 年汶川地震后，不同瘦素基因（LEP）rs7799039 基因型的高中生 PTSD 的发生率和严重程度。
方法
采用基于 DSM-IV-TR 标准的 PTSD 检查表-平民版（PCL-C），在地震后 6、12 和 18 个月对 462 名学生进行 PTSD 症状评估。2018 年，使用聚合酶链反应-限制性片段长度多态性分析（PCR-RFLP），基于 2008 年采集并储存在-80°C 的基因组 DNA，对 LEP rs7799039 基因型进行鉴定，并通过 DNA 测序进行验证。然后采用多种统计方法分析 LEP 基因型与 PTSD 的关系。
结果
12 个月时，AA 纯合子的 PTSD 发生率高于 G 等位基因携带者（22.30%比 10.53%，P=0.013），PCL-C 中位数（四分位距[IQR]）也较高（12 个月时为 27.00[24.00-35.75]比 26.00[22.00-31.25]，P=0.010；18 个月时为 27.00[21.00-32.00]比 24.00[19.00-29.00]，P=0.003）。无论基因型如何，女性学生的 PCL-C 评分均高于男性学生，而仅在 AA 纯合子中，18 个月时的评分更高（27.00[21.00-32.00]比 22.00[18.00-26.00]，P=0.000）。不同时间点 PTSD 严重程度的潜在危险因素和预测因素不同。LEP rs7799039 是 12 个月 PTSD 的潜在因素，也是地震后 18 个月 PTSD 严重程度的预测因素。
结论
本研究在中国青少年中观察到 LEP rs7799039 与 PTSD 的发生率和严重程度之间存在关联。这些结果表明，与携带 G 等位基因的女性相比，LEP rs7799039 AA 基因型的女性 PTSD 特征更为严重，这表明这些女性可能需要进行心理社会或药物治疗。
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