Cem ŞENGÜL, M. Emin ERDAL, Nazan AYDIN, Balcı Ceyhan ŞENGÜL, İBRAHİM ÖMER BARLAS, Şükrü AYNACIOĞLU, Hasan HERKEN

Şizofreni hastalarında olanzapine bağlı kilo alımıyla IRS-1 Gly972Arg (insulin reseptör substratı) gen polimorfizmi arasındaki ilişki

Amaç: İkinci kuşak antipsikotiklere bağlı kilo alımı diyabete ve metabolik sendroma neden olabilen önemli bir problemdir. Son zamanlarda yapılan çalışmalarda antipsikotiklere bağlı kilo alımında genetik etkenlerin rol oynayabileceği belirtilmektedir. Biz bu çalışmada IRS-1 Glyp972Arg gen polimorfizmi ile olanzapine bağlı kilo alımı arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntem: Çalışmaya DSM-IV’e göre şizofreni tanısı konmuş 95 hasta alındı. Hastaların kilosu ve vücut kitle indeksi ve kan glikoz düzeyi çalışmanın başlangıcında ve altı haftalık olanzapin kullanımı sonrasında ölçüldü. Hastalardan alınan kan örnekleri ile genetik analiz yapıldı. Veriler tanımlayıcı yöntemlerle değerlendirildi ve iki grup arasındaki fark Mann-Whitney-U testi ile karşılaştırıldı. Bulgular: Hastaların 84’ü Glisin/Glisin polimorfizmine sahipken, 11’i Glisin/Arjinin polimorfizmine sahipti. Çalışma sonunda Glisin/Glisin polimorfizmine sahip hastalar daha çok kilo almış olmalarına karşın, kilo değişiklikleri ve vücut kitle indeksinde olan değişiklikler arasında istatistiksel olarak anlamlı bir fark yoktu. Sonuç: Sonuçlarımız IRS-1 Gly972Arg polimorfizmi ile olanzapine bağlı kilo alımı arasında bir ilişki bulunmadığını göstermiştir. Ancak diğer IRS genotiplerinin antipsikotiklere bağlı vücut kilo değişikliğiyle ilişkisinin araştırılması antipsikotiklere bağlı kilo alımının düzeneklerini anlamamıza yardımcı olabilir.

The relation between IRS-1 Gly972Arg (insulin receptor substrate) gene polymorphism and olanzapine induced weight gain

Objective: Antipsychotic induced weight gain is a major problem for second generation antipsychotics which may lead to diabetes and metabolic syndrome. Recent studies were mentioning that genetic factors might be relevant in antipsychotic induced weight gain. Aim of this study is evaluation of the association between IRS-1 Glyp972Arg polymorphism and olanzapine induced weight gain. Methods: Total of 95 patients whom were diagnosed as schizophrenia by DSM-IV criteria were included to study. Body weight, body mass index and blood glucose levels of all patients were checked at the beginning and six weeks after olanzapine treatment. Blood for DNA analysis were obtained from patients and analyzed as mentioned in literature. Data were evaluated with descriptive methods and Mann Whitney U test was used for comparison of two groups. Results: Eighty and four of patients had Glycine/Glycine and 11 patients had Glycine/Arginine genotype of IRS-1 Gly972Arg polymorphism. Despite the patients with Glycine/Glycine polymorphism gained more weight than patients with Glycine/Arginine poly-morphism, the difference between Glycine/Glycine and Glycine/Arginine groups for weight change and body mass index change wasn’t statistically significant. Conclusion: Our results showed no statistical relationship between the IRS-1 Gly972Arg polymorphism and olanzapine induced weight gain. However exploration of the other IRS genotypes and the antipsychotic-induced body weight change may help in the understanding of the mechanisms of antipsychotic-induced body weight gain.

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