Association Study Of Apolipoprotein E Genotype With Glucose And Lipid Metabolic Disorder In Senile Schizophrenia

Objective: To explore the association between APOE genotype and schizophrenia in Han Chinese.To explore the influence of APOE genotype on the glucose and lipid metabolic disorder of senile schizophrenia.To understand the influence factors of abnormal glucose and lipid metabolism in senior patients with schizophrenia.Methods: 205 in-patients(106 men and 99 women,Han people,age range 60-87 years)with senile schizophrenia according to ICD-10 who informed consent to this study.243 normal controls(96 men and 147 women,Han people,age range 60-95 years)who informed consent to this study.The basic data collection used in the two groups of the old man including the demographics data,previous medical history and they were also required to measure their weight,height and calculating the body mass index(BMI),test the blood glucose level,blood fat level and other biochemical criterion and APOE genotype.And cases group were collected disease progression and the history of using antipsychotics.The APOE was divided into 3 groups: APOE ?2 group(?2/?2 and ?2/?3),APOE ?3 group(?3/?3),and APOE ?4 group(?2/?4,?3/?4 and ?4/?4).All date were input in computer by Epi Data3.1.The Statistical Package for Social Science(SPSS)version 17.0 was used for analysis and processing of the data.Using x2 test,t test and Z test,we analyzed the difference of glucolipid metabolism between cases group and controls group.APOE allele frequencies of the two groups were calculated using a Hardy-Weinberg equilibrium x2 test for goodness of fit.Using x2 test and Fisher P,we compared the difference between senile schizophrenia and normal controls in the genotype distributions and the frequencies of APOE.Using x2 test,Fisher P,and ANOVA,we analyzed the difference glucose and lipid metabolic disorder among of cases group with different APOE genotypes and controls group with different APOE genotypes.Using x2 test,Fisher P,t test and Z test,we analyzed glucolipid metabolic abnormalities of the single factors in senile schizophrenia.Using x2 test and ANOVA,we compared the taking antipsychotic drugs in senile schizophrenia with different APOE genotypes.Using stepwise logistic regression,we analyzed the influence of three APOE genotypes on the general situation and glucolipid metabolic abnormalities.Using stepwise logistic regression,we analyzed the influential factors on the glucose and lipid metabolic disorder.Results: 1.The compare of glucolipid metabolic situation between senile schizophrenia and normal elders: The community normal elderly with the triglycerides,low density lipoprotein,triglycerides?1.70mmol/L and total cholesterol?5.18mmol/L were higher than elder schizophrenia patients(P < 0.05).2.The associstion between APOE and schizophrenia:(1)APOE allele frequencies of the two groups were calculated using a Hardy-Weinberg equilibrium x2 test for goodness of fit.People have a certain group representative.(2)There was no differences in the genotype distributions(Fish P=0.629)and allele frequencies(x2=1.969,P=0.374)between patients and controls.3.The influence of different APOE genotypes on the glucose and lipid metabolic disorder of senile schizophrenia and community normal elderly: The result of single factor analysis:(1)The senile schizophrenia with different APOE genotypes showed significant difference on the total cholesterol and low density lipoprotein(P<0.05).The senile schizophrenia with different APOE genotypes almost reached significant difference on the low density lipoprotein ?3.37mmol/L(P=0.054).In comparison with study participants carrying APOE ?3 and APOE ?4 genotypes,low density lipoprotein and low density lipoprotein?3.37mmol/L in those with APOE ?2 were significantly lower(P < 0.05).(2)The community normal elderly with different APOE genotypes showed significant difference on the fasting glucose levels(P<0.05).The community normal elderly with different APOE genotypes almost reached significant difference on the fasting glucose levels?6.1mmol/L(P=0.068).In comparison with study participants carrying APOE ?2 and APOE ?4 genotypes,fasting glucose levels in those with APOE ?3 were significantly lower(P < 0.05).Comparisons between genotype groups showed that APOE ?3 carriers exhibited abnormal fasting plasma glucose compared to APOE ?2 carriers to a degree approaching statistical significance(P = 0.065)The result of stepwise logistic regression:(1)APOE ?2 was related to low density lipoprotein of senile schizophrenia.(2)APOE ?2 was related to hyperlipidemia of senile schizophrenia.(3)APOE ?3 was related to fasting glucose levels of community normal elderly.4.The multiple factors analysis on the glucose and lipid metabolic disorder of senile schizophrenia:(1)Abnormal blood sugar was related to gender.(2)Abnormal triglycerides was related to overweight and clozapine.(3)Abnormal total cholesterol was related to gender,course and typical antipsychotic drugs.(4)Abnormal high density lipoprotein was related to gender,quetiapine and overweight.(5)Abnormal low density lipoprotein was related to gender,course,single drug,overweight and APOE ?2.Conclusions: 1.The detection rate of abnormal dyslipidemia in senile schizophrenia was lower than in community normal elderly.2.There was no association between APOE genotype and schizophrenia in Han Chinese.3.There were differences on glucolipid metabolic abnormalities of different APOE genotypes in senile schizophrenia and community normal elderly.The senile schizophrenia patients carrying APOE ?2 might have less hyperlipidemia.APOE ?2 might be protective factors for low density lipoprotein.The senile schizophrenia patients carrying APOE ?4 genotype might have a higher occurrence of hyperlipidemia.The elderly community dwelling residents of Han ethnicity carrying the APOE ?3/?3 genotype might have a higher occurrence of diabetes.APOE ?3 might be dangerous factors for plasma glucose levels.4.Abnormal glucose metabolism was related to gender of senile schizophrenia.Women were more susceptible to glucose metabolism disorder.5.Abnormal lipid metabolism was closely related to gender,course,APOE ?2,overweight,clozapine,typical antipsychotic drugs,quetiapine and single drug of senile schizophrenia.Women,short course,overweight,clozapine and single drug were more susceptible to lipid metabolism disorder.And APOE ?2,typical antipsychotic drugs and clozapine had protective effect to lipid metabolism disorder.