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Abstract
Polymorphism in the Angiotensin I-Converting Enzyme Gene in a Sample of Depressed Egyptian Patients
Presented By : Fatma AbdelKerim AboZahra
To: Chemistry Department - Faculty of Science - Helwan University
This study was conducted on randomly selected 42 in- or out¬patients of depression from the Institute of Psychiatry, Ain Shams University Hospitals. Control subjects were 39. Average age of patients was 34.79±9.1, while it was 35.56±1.2 for control subjects. Regarding the frequency of allele distribution between cases and controls, II polymorphism was encountered more frequently in the control group compared to only 28.6% in the cases. ID polymorphism and DD polymorphism were significantly and frequently found in the cases group than the controls (45.2% and 26.2% versus 25.6% and 17.94% respectively). The majority (69%) had major depression without psychotic features. None of the depressed patients had mild depression. The average number of episodes is 3.2 with a SD±1.5. The mean age of depression onset was 29.3±7.5 years and the illness duration was 5.9±3.8 years. The majority had been hospitalized once (31 %), while a considerable percentage were hospitalized twice (21.4%) and more than twice (26.1 %). On the other hand, 21.4% were not hospitalized at all. Scores obtained by the self administrated Beck Depression Inventory revealed that cases were mainly severe (61.9%) compared to only 38.1 % of moderate cases. On the other hand, scores obtained by Hamilton Depression scale revealed that 26.2% of the cases were classified as severe, 31 % as moderate to severe and 42.9% as mild to moderate. Regarding the type of medications administered
by the studied depression patients, the majority of patients 66.7% received antidepressant only while 33.3% antipsychotic in addition. Also the majority 64.3% did not receive mood stabilizers, almost half of the patients received ECT. Results of studying RAS polymorphism among the studied depression patients showed that the distribution of different allele among depressed patients illustrating higher percentage of ID allele in comparison to II and DD alleles. Although patients with type II polymorphism had their illness at an earlier age than in case of ID and DD groups, yet their duration of illness is the shortest among the other two groups. Patients with ID polymorphism had the largest duration of illness (p<0.001) followed by DD group. Patients’ condition necessitate hospitalization was the highest among ID group compared to DD and II (p=.0009). Moreover ID group showed the longest mean duration of hospitalization. It seems that psychiatric co-morbidity has no relation to ACE polymorphism. The most severe depression cases were in the ill group (78.9%) compared with DD group (63.6%) and II group (33.3%) (P value = 0.039). Serum cortisol in patients show the highest value in the ID polymorphism while II polymorphism shows the lowest value of a.m. cortisol. Data illustrated a significant association of ID polymorphism with the more severity of illness, the more number of episodes and the high percentage of patients with very severe depression according to Hamilton scale. Patients with ill polymorphism have significant longer duration of illness, more mean number of previous admission longer duration of hospitalization and higher level of serum cortisol level than did the non-ill polymorphism patients.
KeyWords
ACE polymorphism - depression - contisol-HP A axis