Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pharmacoepidemiol Drug Saf. 2021 Jun;30(6):806-813. doi: 10.1002/pds.5224. Epub 2021 Mar 23.
The use of Atypical antipsychotics (AAPs) is related to metabolic disturbances, which put psychiatric patients at risk for cardiovascular morbidity and mortality. Evidence is emerging of genetic risk factors. The HTR2C gene is an essential candidate in pharmacogenetic studies of antipsychotic-induced metabolic effects. Nevertheless, there were inconsistent results among studies.
To investigate the relationship between -759C/T, functional polymorphism of the HTR2C gene and metabolic adverse effects in Thai psychiatric patients treated with risperidone monotherapy.
In this cross-sectional study, 108 psychiatric patients treated with risperidone monotherapy for ≥3 months were recruited. Anthropometric measurements and laboratory tests were obtained upon enrollment and history of treatment was reviewed from medical records. Weight gain was defined as an increase ≥7% of baseline weight. Metabolic syndrome was evaluated according to the 2005 International Diabetes Federation (IDF) Asia criteria. The -759C/T, polymorphism was genotyped. The associations between -759C/T polymorphism and metabolic side effects were analyzed. Multiple logistic regression was used for determining potential confounders.
Neither weight gain nor metabolic syndrome was significantly associated with -759C/T allelic and genotype variants of HTR2C. However, T allele of -759C/T polymorphism significantly associated with the hypertension. This association was not affected by possible confounding factors such as gender, risperidone dose, duration of treatment and family history of hypertension.
Our findings suggest that psychiatric patients with T allele of -759C/T polymorphism may be at higher risk for hypertension. Further study with prospective design with larger patient groups are needed.
使用非典型抗精神病药物（AAPs）与代谢紊乱有关，这使精神科患者面临心血管发病率和死亡率的风险。有遗传风险因素的证据正在出现。HTR2C 基因是抗精神病药引起的代谢作用遗传药理学研究的一个重要候选基因。然而，研究结果并不一致。
研究 HTR2C 基因-759C/T 多态性与泰国接受利培酮单药治疗的精神科患者代谢不良的关系。
在这项横断面研究中，招募了 108 名接受利培酮单药治疗≥3 个月的精神科患者。在入组时进行了人体测量学测量和实验室检查，并从病历中回顾了治疗史。体重增加定义为基线体重增加≥7%。根据 2005 年国际糖尿病联合会（IDF）亚洲标准评估代谢综合征。对-759C/T 多态性进行了基因分型。分析了-759C/T 多态性与代谢副作用之间的关系。使用多元逻辑回归来确定潜在的混杂因素。
HTR2C 的-759C/T 等位基因和基因型变体与体重增加或代谢综合征均无显著相关性。然而，-759C/T 多态性的 T 等位基因与高血压显著相关。这种关联不受性别、利培酮剂量、治疗持续时间和高血压家族史等可能的混杂因素的影响。
我们的研究结果表明，-759C/T 多态性的 T 等位基因的精神科患者可能患高血压的风险更高。需要进一步设计前瞻性研究，纳入更大的患者群体。
