정신분열병 환자에서 인슐린 및 포도당 투여후 혈장 단가아민 대사물질의 농도 변화와 임상적 변인과의 관련성
(The) Relationship between changes of plasma monoamine metabolites concentration and clinical variables after insulin and glucose loading in patients with schizophrenia
정신분열병 인슐린 포도당 임상적변인 의학;
- 원문 URL
The 5-hydroxytryptamine (5-HT), dopamine (DA) and norepinephrine (NE) are major monoamine neurotransmitters in central nervous system. Many researchers are trying to find out their significances in the etiopathogenesis of schizophrenic illness. The author investigated the possibility of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and 3-methoxy-4-hydroxy-phenylglycol (MHPG) concentrations in plasma as biological markers in patients with schizophrenia Twenty-six subjects with schizophrenia taking antipsychotics were enrolled in this study. Insulin and glucose loading tests were attempted in each patient. First baseline plasma was obtained at 8:00 AM. Regular insulin (0.15 unit/kg) was administered after baseline sampling and the second sampling was done at 9:00 AM. One week later second baseline plasma was obtained at 8:00 AM. Glucose (150 gm) was taken orally after baseline sampling and the second sampling was done at 9:00 AM. The correlations of baseline concentrations of metabolites were analyzed. The significant changes of metabolites after insulin and glucose loading were analyzed. The difference between HVA and MHPG was approximated as central dopaminergic index (CDI). The significances of ratio, 5-HIAA/HVA, were computed and analyzed. The data were analyzed with clinical variables, such as age, age of onset, duration of illness and clinical state. The HIAA, HVA and MHPG levels were assayed using high pressure liquid chromato-graphy-electrochemical detection method. There was a minimal day-to-day variation of three major monoamine metabolites. Two baseline levels of all three metabolites were highly correlated. The HVA levels increased significantly after insulin administration in total subjects. The CDI also increased significantly after insulin loading. The HVA and MHPG levels decreased significantly after glucose intake in total subjects. A significant association was observed between the age of onset and baseline HVA level. The early onset group had a higher levels of HVA and CDI than the late onset group. The early onset group had a lower 5-HIAA/HVA ratio of baseline plasma. This trend was amplified after glucose intake. The present findings suggest that the plasma 5-HIAA, HVA and MHPG levels can be used as biological markers for subgrouping of schizophrenia. The age of onset may be a clinical marker which is closely related with biological indices. Schizophrenia can be subgrouped by different activities of 5-HT, DA and NE.