潘鑫　　李建华　　陶百平　　陈华　　夏青春　　黄光彪

[摘要] 目的 研究首發精神分裂症患者糖代谢异常与血清IL-1β、IL-1Rα水平及BDNFrs6265基因多态性的关系。 方法 前瞻性选取2017年1月至2020年1月于我院治疗的首发精神分裂症患者220例为SCH组，另选取同期健康体检者100例为NC组。检测其空腹血糖水平和2 h血糖水平，并根据是否存在糖代谢异常将SCH组分为AGM组100例和NGM组120例。比较各组之间FPG、BPG以及IL-1β、IL-1Rα水平和BDNFrs6265基因分布及浓度，采用Pearson相关性分析以上因子相关性。 结果 三组受试者FPG、BPG和IL-1β水平表现为AGM组>NGM组>NC组，IL-1Rα水平表现为AGM组

[关键词] 精神分裂症;糖代谢异常;BDNFrs6265基因;血清IL-1β

[中图分类号] R749.3          [文献标识码] B          [文章编号] 1673-9701（2021）12-0054-05

Relation between abnormal glucose metabolism and serum IL-1β，IL-1Rα levels and BDNFrs6265 gene polymorphism in first-episode schizo-phrenia patients

PAN Xin   LI Jianhua   TAO Baiping   CHEN Hua   XIA Qingchun   HUANG Guangbiao

Department of Psychiatry， the Third People′s Hospital of Huzhou City in Zhejiang Province， Huzhou   313000， China

[Abstract] Objective To research the correlation between abnormal glucose metabolism and serum IL-1β， IL-1Rα levels and BDNFrs6265 gene polymorphism in first-episode schizophrenia patients. Methods A total of 220 patients with first-episode schizophrenia treated in our hospital from January 2017 to January 2020 were prospectively selected as the SCH group（n=220）， while another 100 healthy people examined in the same period were selected as the NC group（n=100）. The fasting blood glucose level and 2-hour blood glucose level were detected， and the SCH group was divided into the AGM group（n=100） and the NGM group（n=120） according to the presence of abnormal glucose metabolism. The levels of FPG， BPG， IL-1β， IL-1Rα and the distribution and concentration of BDNFrs6265 gene were compared among the groups. Pearson test was used to analyze the correlation between the above factors. Results The levels of FPG， BPG and IL-1β in the three groups were the AGM group >the NGM group > the NC group， while the levels of IL-1Rα were the AGM group < the NGM group < the NC group（P<0.05）. The genotypes of BDNFrs6265 could be divided into three types of GG， AA and GA. The ratio of AA genotype and A allele in the AGM group was higher than that in the NGM group and the NC group，and the comparison of genotype concentration between any two groups showed that the AGM group < the NGM group < the NC group in turn（P<0.05）. It was shown by Pearson test that FPG was positively correlated with the level of IL-1β（r=0.467， P<0.001） and negatively correlated with the levels of IL-1Rα， GG， GA and AA（r=-0.673， -0.526， -0.548， -0.437， P<0.001）. BPG was positively correlated with IL-1β（r=0.502，P<0.001） and negatively correlated with IL-1Rα， GG， GA and AA（r=-0.383， -0.470， -0.531， -0.462， P<0.001）. The level of IL-1β was negatively correlated with the concentration of GG， GA and AA（r=-0.559， -0.513， -0.490， P<0.001）， and the level of IL-1Rα was negatively correlated with the concentration of GG， GA and AA（r=0.486， 0.563， 0.348， P<0.001）. Conclusion The genes IL-1β，IL-1Rα and BDNFrs6265 may be involved in the pathogenesis of abnormal glucose metabolism in schizophrenic patients and have an important relationship with abnormal glucose metabolism. The relatively high incidence of abnormal glucose metabolism in schizophrenic patients is not entirely caused by antipsychotics. Inflammatory reaction and genetic factors in vivo can also lead to abnormal glucose metabolism.

[Key words] Schizophrenia; Abnormal glucose metabolism; BDNFrs6265 gene; Serum IL-1β

精神分裂症（Schizophrenia，SCH）是一种严重的精神障碍疾病，多在青壮年时期慢性起病，主要症状涉及感知觉、思维、情感和行为等多方面障碍和精神活动的不协调[1]。糖代谢异常为内分泌代谢疾病，包含血糖升高和降低两种情况。其中血糖升高主要发病原因是由于胰岛素分泌不足或靶细胞对胰岛素敏感性降低而引起机体内糖、蛋白质、脂肪及水电解质代谢紊乱[2]。流行病学研究发现，精神分裂症患者中出现糖代谢异常的概率是普通人群的2～4倍[3]，对于具体机制目前尚不明确。部分学者认为是由抗精神病药物所致，另有一些学者持相反观点[4]。有研究报道，白介素-1β（Interleukin-1β，IL-1β）及白介素1受体拮抗剂（Interleukin-1 receptor antagonist，IL-1Rα）与糖尿病的发展有重要关联[5]，而脑源性神经营养因子（Brain-derived neurotrophic factor，BDNF）也参与了糖代谢过程[6]，其中崔力军等[7]学者对BDNF基因rs6265多态性与首发SCH患者糖代谢异常的关系进行研究，但并未将IL-1β、IL-1Rα纳入研究。因此……