Wang Xuan, Xiu Meihong, Wang Keqiang, Su Xiuru, Li Xirong, Wu Fengchun
Hebei Province Veterans Hospital, Baoding, China.
Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China.
Metabolomics. 2022 Jul 11;18(7):50. doi: 10.1007/s11306-022-01909-4.
Olanzapine (OLA) is one of the most commonly used second-generation antipsychotics for the treatment of schizophrenia. However, the heterogeneity of therapeutic response to OLA among schizophrenia patients deserves further exploration. The role of carnitine in the clinical response to OLA monotherapy remains unclear.
The current study was designed to investigate whether carnitine and its derivatives are linked to the response to OLA treatment. Drug-naïve first-episode patients with schizophrenia were recruited and treated with OLA for 4 weeks. Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) in pre and post treatment.
After treatment, we found a significant decrease in 2-Octenoylcarnitine levels and a significant increase in linoelaidyl carnitine, 11Z-Octadecenylcarnitine and 9-Decenoylcarnitine levels. Furthermore, baseline linoelaidyl carnitine levels were correlated with the reduction of PANSS positive symptom subscore. Linear regression and logistic regression analyses found that the baseline linoelaidyl carnitine level was a predictive marker for the therapeutic response to OLA monotherapy for 4 weeks.
Our pilot study suggests that linoelaidyl carnitine levels at baseline may have a predictive role for the improvement of positive symptoms after OLA monotherapy in the patients with schizophrenia.
奥氮平（OLA）是治疗精神分裂症最常用的第二代抗精神病药物之一。然而，精神分裂症患者对OLA治疗反应的异质性值得进一步探索。肉碱在OLA单药治疗临床反应中的作用仍不明确。
本研究旨在调查肉碱及其衍生物是否与OLA治疗反应有关。招募未使用过药物的首发精神分裂症患者，用OLA治疗4周。治疗前后使用阳性和阴性症状量表（PANSS）评估精神症状。
治疗后，我们发现2-辛烯酰肉碱水平显著降低，亚油酸肉碱、11Z-十八烯酰肉碱和9-癸烯酰肉碱水平显著升高。此外，基线亚油酸肉碱水平与PANSS阳性症状亚评分的降低相关。线性回归和逻辑回归分析发现，基线亚油酸肉碱水平是4周OLA单药治疗反应的预测指标。
我们的初步研究表明，基线亚油酸肉碱水平可能对精神分裂症患者OLA单药治疗后阳性症状的改善具有预测作用。
