Chen Yan, Wang Yewei, Fang Xinyu, Zhang Yi, Song Lisheng, Zhang Chen
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine Affiliated Shanghai Mental Health Center, Shanghai, China.
Gen Psychiatr. 2020 May 14;33(3):e100192. doi: 10.1136/gpsych-2020-100192. eCollection 2020.
Antipsychotic-induced weight gain (AIWG) is a crucial factor for the medication cessation of patients with schizophrenia. Multiple studies have shown that the functional polymorphism -759 C/T (rs3813929) in the promoter region could possibly be correlated with AIWG.
To evaluate the genetic association of the HTR2C-759C/T polymorphism and AIWG in patients with schizophrenia with antipsychotic drugs (APDs) administration.
Eligible studies were identified by searching the following databases: PubMed, Embase, Web of Science, China Nation Knowledge Infrastructure (CNKI), VIP, Wanfang Data, Chinese Biomedical Literature Database (CBM) and the Airiti Library. The quality of studies was evaluated based on the Newcastle-Ottawa Scale. The pooled OR and 95% CI were calculated for the dominant (CT/TT/T vs CC/C) mode, and subgroup analyses were performed based on ethnicity, antipsychotic medication and gender; all statistical analyses were performed using the statistical software STATA V.12.0.
A total of 17 studies with 3170 patients with schizophrenia were included in our meta-analysis. The result of the meta-analysis has shown that the association between the -759 C/T polymorphism and AIWG is statistically significant (OR 0.34, 95% CI: 0.20 to 0.57, z=4.11, p<0.001). The subgroup analyses revealed significant correlations between the -759 C/T polymorphism and AIWG in the Caucasian population (OR 0.33, 95% CI: 0.14 to 0.77, z=2.55, p=0.011), the Asian population (OR 0.31, 95% CI: 0.18 to 0.52, z=4.46, p<0.001), the patients with APDs administration (CT/TT/T vs CC/C: OR 0.63, 95% CI: 0.40 to 1.00, z=1.97, p=0.049) and the patients with atypical antipsychotic drug administration (CT/TT/T vs CC/C: OR 0.21, 95% CI: 0.09 to 0.47, z=3.83, p<0.001). The sensitivity analysis showed that the results were stable. Begg's test (after correction z=1.07, p=0.287) and Egger's test (t=-2.41, p=0.029) show that the included articles have no significant publication bias.
There is a significant genetic association between -759C/T and AIWG, and patients with T allele are less likely to have AIWG.
抗精神病药物所致体重增加（AIWG）是精神分裂症患者停药的关键因素。多项研究表明，启动子区域的功能性多态性-759 C/T（rs3813929）可能与AIWG相关。
评估精神分裂症患者使用抗精神病药物（APD）时，5-羟色胺受体2C基因（HTR2C）-759C/T多态性与AIWG之间的遗传关联。
通过检索以下数据库确定符合条件的研究：PubMed、Embase、科学引文索引（Web of Science）、中国知网（CNKI）、维普资讯（VIP）、万方数据、中国生物医学文献数据库（CBM）和华艺数位图书馆（Airiti Library）。基于纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）评估研究质量。计算显性模式（CT/TT/T vs CC/C）下的合并比值比（OR）和95%置信区间（CI），并根据种族、抗精神病药物使用情况和性别进行亚组分析；所有统计分析均使用统计软件STATA V.12.0进行。
我们的荟萃分析共纳入17项研究，涉及3170例精神分裂症患者。荟萃分析结果显示，-759 C/T多态性与AIWG之间的关联具有统计学意义（OR 0.34，95%CI：0.20至0.57，z=4.11，p<0.001）。亚组分析显示，-759 C/T多态性与白种人群（OR 0.33，95%CI：0.14至0.77，z=2.55，p=0.011）、亚洲人群（OR 0.31，95%CI：0.18至0.52，z=4.46，p<0.001）、使用APD的患者（CT/TT/T vs CC/C：OR 0.63，95%CI：0.40至1.00，z=1.97，p=0.049）以及使用非典型抗精神病药物的患者（CT/TT/T vs CC/C：OR 0.21，95%CI：0.09至0.47，z=3.83，p<0.001）中的AIWG存在显著相关性。敏感性分析表明结果稳定。Begg检验（校正后z=1.07，p=0.287）和Egger检验（t=-2.41，p=0.029）表明纳入的文章无显著发表偏倚。
-759C/T与AIWG之间存在显著的遗传关联，携带T等位基因的患者发生AIWG的可能性较小。
