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目的探讨5-羟色胺(5-HT)系统5-HT2A受体基因(HTR2A)-1438A/G和色氨酸羟化酶基因(TPH1)-6526A/G多态性及其他相关因素对注意缺陷多动障碍(ADHD)智商的影响。方法根据美国《精神障碍诊断与统计手册》4版(DSM-Ⅳ)中ADHD诊断标准,共入组366例汉族ADHD患儿,采用中国韦氏儿童智力量表(C-WISC)评定ADHD患儿的智商(IQ),应用限制性片断长度多态性检测HTR2A的-1438A/G和TPH1的-6526A/G的多态性,收集家庭一般情况(包括父母亲受教育程度)。按照基因型将患儿分为GG、GA和AA3组,同时按父母的受教育程度(初中及以下,高中、中专和大专,大学本科及以上)将患儿分为3组。结果HTR2A的-1438A/G的GG、GA和AA3个基因型组患儿全量表智商(FIQ)和言语智商(VIQ)的差异均有统计学意义(F=5.238 P=0.006)(F=6.052 P=0.003);经两两比较,GG和GA基因型组间的差异有统计学意义[P(FIQ)=0.003,0.042;P(VIQ)=0.001,0.032],GG基因型得分明显高于GA和AA组。TPH1的-6526A/G各基因型组间IQ的差异无统计学意义。按父亲的受教育程度分组时,3组患儿FIQ及VIQ的差异有统计学意义(F=3.664 P=0.027;F=5.261 P=0.006);按母亲的受教育程度分组时,3组患儿FIQ及VIQ的差异有统计学意义(F=4.894 P=0.008;F=5.043 P=0.007)。经多因素分析,HTR2A基因型和母亲受教育程度进入回归方程,二者均对患儿的FIQ和VIQ有影响。结论HTR2A的-1438A/G多态性及母亲的受教育程度与中国汉族ADHD患儿的智商相关。
Objective To investigate the polymorphisms of 5-HT2A receptor gene (HTR2A) -1438A / G and tryptophan hydroxylase gene (TPH1) -6526A / G in serotonin (5-HT) system and other related factors Impairment disorder (ADHD) IQ effect. Methods A total of 366 Han children with ADHD were enrolled in this study according to the ADHD diagnostic criteria in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ), and children with ADHD were assessed by C-WISC IQ was used to detect the -1426A / G of HTR2A and -6526A / G of TPH1 by restriction fragment length polymorphism (PCR). The general family situation (including the level of parental education) was collected. The children were divided into GG, GA and AA3 groups according to their genotypes. At the same time, children were divided into 3 groups according to their parents’ education level (junior high school and below, high school, technical secondary school and college, undergraduate and above). Results The differences of FIQ and VIQ in GG, GA and AA3 genotypes of -1438A / G HTR2A were statistically significant (F = 5.238 P = 0.006) (F = 6.052 P = 0.003,0.042; P (VIQ) = 0.001,0.032]. The GG genotype score was significantly higher than that of the GG genotype GA and AA group. There was no significant difference in IQ between the -6526A / G genotypes of TPH1. There were significant differences in FIQ and VIQ between the three groups (F = 3.664 P = 0.027; F = 5.261 P = 0.006) when grouped according to their father’s education level. When grouped according to their mother’s education level, Differences in FIQ and VIQ were statistically significant (F = 4.894 P = 0.008; F = 5.043 P = 0.007). After multivariate analysis, HTR2A genotype and mother’s education level entered the regression equation, both of which had effects on FIQ and VIQ in children. Conclusion The -1438A / G polymorphism of HTR2A and maternal education level are related to IQ in Chinese Han children with ADHD.