RESUMO
AIM: The occurrence of metabolic syndrome (MS) in schizophrenia patients receiving long-term antipsychotics (APs) contributes to their high mortality rate. We aimed to determine whether genetic polymorphisms of identified candidate genes are associated with MS in our study population. MATERIALS & METHODS: We recruited 206 schizophrenia patients receiving AP treatment for at least a year. Cross-sectional measurements of weight, height, blood pressure, waist and hip circumference, and other lipid profiles were recorded. Patient DNA was genotyped for 16 candidate gene polymorphisms. RESULTS: Of these patients, 59.7% were found to have MS while 40.3% did not. All metabolic parameters were significantly different between the two groups. Only three of the 16 polymorphisms studied showed significant association with MS; rs9939609 of the FTO gene confers risk for MS (odds ratio [OR]: 1.73, 95% CI: 1.07-2.78, p = 0.026), while rs1137101 of the LEPR gene (OR: 0.47, 95% CI: 0.28-0.80, p = 0.005) and rs1801133 of the MTHFR gene (OR: 0.59, 95% CI: 0.35-0.99, p = 0.049) are protective against MS. CONCLUSION: Polymorphisms of the FTO, LEPR and MTHFR genes may play a role in MS in Malaysian schizophrenia patients receiving long-term treatment with APs.
Assuntos
Antipsicóticos/uso terapêutico , Síndrome Metabólica/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Polimorfismo de Nucleotídeo Único/genética , Proteínas/genética , Receptores para Leptina/genética , Esquizofrenia/tratamento farmacológico , Adulto , Dioxigenase FTO Dependente de alfa-Cetoglutarato , Antipsicóticos/efeitos adversos , Estudos Transversais , Feminino , Genótipo , Humanos , Masculino , Síndrome Metabólica/induzido quimicamente , Risco , Esquizofrenia/genéticaRESUMO
OBJECTIVES: Various genetic polymorphisms have been reported to be associated with antipsychotic-induced weight gain. In this study, we aimed to determine whether risk polymorphisms in 12 candidate genes are associated with reduction in body mass index (BMI) of patients following switching of antipsychotics to aripiprazole or ziprasidone. METHODS: We recruited 115 schizophrenia patients with metabolic abnormalities and who have been on at least 1 year treatment with other antipsychotics; they were then switched to either aripiprazole or ziprasidone. They were genotyped, and their BMI monitored for 6 months. RESULTS: Significant associations with reduction in BMI at 6 months following switching were found in two of these genes: with rs1800544 of the ADRA2A gene (CC + CG [-0.32 ± 1.41 kg/m²] vs GG [-1.04 ± 1.63 kg/m²], p = 0.013) and with rs1801131 of the MTHFR gene (AA [-0.36 ± 1.53] vs AC + CC [-1.07 ± 1.53], p = 0.015). CONCLUSION: The study data indicated that carriage of the ADRA2A rs1800544 GG genotype and the MTHFR rs1801131 C allele are associated with BMI reduction in this population following switching of antipsychotics to aripiprazole and ziprasidone.
Assuntos
Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Piperazinas/uso terapêutico , Quinolonas/uso terapêutico , Receptores Adrenérgicos alfa 2/genética , Tiazóis/uso terapêutico , Redução de Peso/genética , Adulto , Alelos , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Aripiprazol , Índice de Massa Corporal , Feminino , Seguimentos , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Piperazinas/efeitos adversos , Polimorfismo Genético , Quinolonas/efeitos adversos , Esquizofrenia/tratamento farmacológico , Tiazóis/efeitos adversos , Aumento de Peso/efeitos dos fármacosRESUMO
Objective: In Malaysia, opioid abuse is an acknowledged problem with severe health and economic repercussions. Until recently, drug addicts were mainly criminalised and forcefully rehabilitated in correctional facilities. However, the high relapse rates of this approach, coupled with the high rates of blood borne infections among drug users, led to increasing acceptance of a healthcare-based approach in the rehabilitation of drug addicts. Methadone was among the medications introduced as substitution maintenance therapy in 2005 and Universiti Malaya Medical Centre (UMMC) is a centre for MMT. This study aimed to determine the effects of MMT on quality of life in patients here. Methods: The sample was 46 patients who attended the Psychiatric outpatient clinic in fill in UMMC. The instrument used to assess quality of life was the WHOQOL-BREF. Results: The study design was cross-sectional with retrospective elements. Baseline QOL scores were obtained from case records and follow-up scores from the month of September 2007. Statistically significant improvements in all four domains of WHOQOL-BREF were found. Physical: p<0.01, C.I. 1.46-3.05. Psychological: p<0.01, C.I. 1.44-3.11. Social: p=0.03, C.I. 0.66-3.05. Environmental: p<0.01, C.I. 0.85-2.24. Conclusion: Methadone maintenance therapy substantially improves quality of life in ex-opioid abusers.
