bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2020-1-52-63bekhterev-384Research ArticleИССЛЕДОВАНИЯINVESTIGATIONSTaqIA полиморфизм гена ANKK1/DRD2 (rs1800497) как генетический маркер нарушений пищевого поведения, ассоциированных с пищевой зависимостью, у пациентов с избыточной массой телаANKK1/DRD2 gene Taq1A polymorphism (rs1800497) as a possible genetic marker of food-addiction-related eating disturbances in overweight patientsКибитовА. А.KibitovA. A.

Кибитов Андрей Александрович — студент 6-го курса Факультета фундаментальной медицины

andreykibitov18@gmail.comКасьяновЕ. Д.KasyanovE. D.

Касьянов Евгений Дмитриевич — аспирант 

Санкт-Петербург

Saint-Petersburg

ohkasyan@yandex.ruРукавишниковГ. В.RukavishnikovG. V.

Рукавишников Григорий Викторович -к.м.н., н.с. отделения эндокринологической психиатрии 

Санкт-Петербург

Saint-Petersburg

grigory_v_r@mail.ruЧупроваН. А.ChuprovaN. A.

Чупрова Наталья Александровна — научный сотрудник лаборатории молекулярной генетики 

Москва

Moscow

chuprova.natalya.2014@mail.ruБобровскийА. В. BobrovskyA. V.

Бобровский Андрей Вениаминович — к.м.н., доцент кафедры психотерапии и клинической психологии медицинского факультета

a2104141@gmail.comМазоГ. Э.MazoG. E.

Мазо Галина Элевна — д.м.н., ученый секретарь, руководитель отделения эндокринологической психиатрии

Saint-Petersburg

galina-mazo@yandex.ruФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»РоссияLomonosov Moscow State UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава РоссииРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyRussian FederationФГБУ «Национальный медицинский исследовательский центр психиатрии и наркологии имени В.П. Сербского» Минздрава РоссииРоссияSerbsky National Medical Research Center on Psychiatry and AddictionsRussian FederationФГБОУ ВО «Санкт-Петербургский государственный университет»РоссияSaint Petersburg State UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава России, Санкт-ПетербургРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyRussian Federation202002042020015263Copyright © Кибитов А.А., Касьянов Е.Д., Рукавишников Г.В., Чупрова Н.А., Бобровский А.В., Мазо Г.Э., 20202020Кибитов А.А., Касьянов Е.Д., Рукавишников Г.В., Чупрова Н.А., Бобровский А.В., Мазо Г.Э.Kibitov A.A., Kasyanov E.D., Rukavishnikov G.V., Chuprova N.A., Bobrovsky A.V., Mazo G.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/384

Борьба с эпидемией избыточного веса и ожирения считается одним из важнейших вызовов для современного здравоохранения, особенно в странах с высоким уровнем дохода. Одной из возможных причин переедания и, следовательно, избыточного веса является приступообразное переедание, которое ряд исследователей рассматривает в рамках пищевой зависимости.

Для оценки ассоциации полиморфизма TaqI гена ANKK1/DRD2 (rs1800497), связанного с большинством химических и поведенческих зависимостей, с клиническими особенностями расстройств пищевого поведения (РПП) проведено кросс-секционное исследование с участием 527 пациентов европейского происхождения с избыточным весом (469 (89,0%) женщин, 58 (11,0%) мужчин; М±σ: ИМТ — 35,8±7,3 кг/м2; возраст — 46,7±11,8 лет). Для оценки клинических и психологических аспектов РПП применялись опросники Eating Disorder Examination — Questionnaire (EDE-Q); Eating Attitudes Test (EAT-26); Dutch Eating Behavior Questionnare (DEBQ). Также использовались методы для оценки выраженности аффективной (HADS (Hospital Anxiety and Depression Scale), HRDS (Hamilton Rating Scale for Depression), HARS (Hamilton Anxiety Rating Scale)) и обсессивно-компульсивной симптоматики (Y-BOCS (Yale-Brown Obsessive-Compulsive Scale). Для детекции полиморфизма использовался метод ПЦР в реальном времени.

На основании результатов генотипирования согласно доминантной модели генетического эффекта выборка была разделена на две группы: носители вариантного (минорного) аллеля TaqI (группа «СT+TT») и гомозиготы по (мажорному) аллелю дикого типа (группа «СС»). Пациенты из группы «CT+TT» демонстрировали более высокий балл по EDE-Q (p=0,075), а также были несколько моложе (р=0,063).Кроме того, по сравнению с группой «СС» данные пациенты имели более высокий риск развития проявлений РПП: 1) По EAT-26 — 15,2% vs. 9,0%, ОШ=1,82 (ДИ95% (1,054-3,134), p=0,03); 2) по EDE-Q — 46,6% vs. 37,5%, ОШ=1,45 (CI95% (1,015-2,072), p=0,041). ИМТ коррелировал с баллом по подшкале эмоциогенного пищевого поведения DEBQ только в группе «СТ+ТТ» (ρs =0,199, p=0,004). В данной группе не было обнаружено статистически значимых корреляций между баллами по шкалам, оценивающим аффективную симптоматику и EDE-Q.

Таким образом, была обнаружена связь между ассоциированным с аддикциями TaqI полиморфизмом гена ANKK1/DRD2 и выраженностью проявлений РПП у пациентов с избыточной массой тела, что позволяет предположить роль аддиктивных процессов в развитии переедания и увеличения массы тела.

Controlling the epidemic of overweight and obesity is one of the major challenges to modern healthcare. One of the possible causes of overweight and obesity can be food addiction manifesting as overeating and other eating disturbances (ED).

We conducted a cross-sectional study to test the association between addiction-related ANKK1/DRD2 gene Taq1A polymorphism (rs1800497) and ED in overweight patients. Overall, 527 outpatients (469 (89,0%) females, 58 (11,0%) males; mean ± SD: BMI — 35,8±7,3 kg/m2; age — 46,7±11,8 years) of European ancestry were included in the study. Eating Disorder Examination — Questionnaire (EDE-Q), Eating Attitudes Test (EAT-26) and Dutch Eating Behavior Questionnaire (DEBQ) were used to assess the ED. We also used Hospital Anxiety and Depression Scale (HADS), Hamilton Rating Scale for Depression (HRDS), Hamilton Anxiety Rating Scale (HARS) and Yale-Brown Obsessive-Compulsive Scale (YBOCS) to assess depressive, anxiety and obsessive-compulsive disturbances respectively. DNA was extracted from blood samples and polymorphism rs1800497 was detected by RT-PCR.

According to the dominant genetic model, carriers of minor T allele (“CT+TT” group) in contrast to wild-type allele homozygous patients (“CC” group) were younger (p=0,075) and demonstrated higher scores of EDE-Q (p=0,085) and emotional eating subscale of DEBQ (p=0,063). Moreover, among them the proportion of patients with high ED risk was significantly increased vs. CC group: 1) EAT-26 score: 15,2% vs. 9,0%, OR=1,82 (CI95% (1,054-3,134), p=0,03; 2) EDE-Q score: 46,6% vs. 37,5%, OR=1,45 (CI95% (1,015-2,072), p=0,041. BMI was correlated with emotional eating subscale of DEBQ score in “CT+TT” group only (ρs =0,199, p=0,004). Correlation analysis showed weaker connections between ED and affective disturbances in “CT+TT” group.

Our results show that carriers of the addiction-related T allele of ANKK1/DRD2 gene Taq1A polymorphism comprise the at-risk group for eating disturbances in overweight individuals. This may support the role of food addiction in overweight and obesity.

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The authors declare that there are no conflicts of interest present.