Second-generation antipsychotics (SGAs) are increasingly being used to treat children with a variety of psychiatric illnesses. Metabolic syndrome (MetS), a risk factor for cardiovascular disease, is a side-effect of SGA-treatment. We conducted a cross-sectional study and assessed the association of the methylenetetrahydrofolate reductase (MTHFR) C677T variant with features of MetS in SGA-treated (n=105) and SGA–naïve (n=112) children. We targeted the MTHFR C677T variant, because it is associated with risk for cardiovascular disease, and features of MetS in adults without psychiatric illness. MetS in children is based on the presence of any three of the following: waist circumference ⩾90th percentile for age and sex; plasma triglyceride ⩾1.24 mmol l−1; plasma high-density lipoprotein-cholesterol ⩽1.03 mmol l−1; systolic or diastolic blood pressure ⩾90th percentile for age, sex, and height; and fasting glucose ⩾5.6 mmol l−1. We found that 15% of SGA-treated children had MetS compared with 2% of SGA-naïve children (OR 8.113, P<0.05). No effect of the MTHFR C677T variant on psychiatric diagnosis was observed. The MTHFR 677T allele was associated (P<0.05) with MetS (OR 5.75, 95% CI= 1.18–28.12) in SGA-treated children. Models adjusted for duration of SGA treatment, ethnicity, sex, age and use of other medications revealed a positive relationship between the MTHFR 677T allele and diastolic blood pressure Z-scores (P=0.001) and fasting plasma glucose (P<0.05) in SGA-treated children. These findings illustrate the high prevalence of MetS in SGA-treated children and suggest metabolic alterations associated with the MTHFR C677T variant may have a role in the development of MetS features in SGA-treated children.
展开▼
机译:第二代抗精神病药(SGA)越来越多地用于治疗患有各种精神疾病的儿童。代谢综合症(MetS)是心血管疾病的危险因素,是SGA治疗的副作用。我们进行了一项横断面研究,评估了SGA治疗(n = 105)和SGA初次(n = 112)儿童中亚甲基四氢叶酸还原酶(MTHFR)C677T变异体与MetS特征的关联。我们针对的是MTHFR C677T变体,因为它与罹患心血管疾病的风险以及未患有精神病的成年人的MetS特征有关。儿童的MetS取决于以下三种情况:腰围:年龄和性别的第90个百分点;血浆甘油三酸酯⩾1.24mmol l -1 sup>;血浆高密度脂蛋白胆固醇⩽1.03mmol l -1 sup>;收缩压或舒张压for年龄,性别和身高的百分之九十;和空腹血糖⩾5.6mmol l -1 sup>。我们发现,接受SGA治疗的儿童中有15%患有MetS,而没有SGA的儿童中只有2%具有MetS(OR 8.113,P <0.05)。没有观察到MTHFR C677T变体对精神病学诊断的影响。在接受SGA治疗的儿童中,MTHFR 677T等位基因与MetS相关(P <0.05)(OR 5.75,95%CI = 1.18–28.12)。调整了SGA治疗持续时间,种族,性别,年龄和其他药物使用的模型显示,MTHFR 677T等位基因与SGA中舒张压Z评分(P = 0.001)和空腹血糖(P <0.05)之间呈正相关治疗的孩子。这些发现说明在经SGA治疗的儿童中MetS的患病率很高,并表明与MTHFR C677T变体相关的代谢改变可能在经SGA治疗的儿童中MetS功能的发展中起作用。
展开▼