Zhenhua Wang,1 Jing Li,2 Haizhi Chen,1 Haiying Jin,1 Shiliang Wang,1 Xuqiang Hu1 

1Department of Psychiatry, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, People’s Republic of China; 2Center for Disease Control and Prevention, Huzhou City, Zhejiang, People’s Republic of China

Correspondence: Xuqiang Hu, Department of psychiatry, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, People’s Republic of China, Email huxuqiang@hz3rd-hosp.cn

Purpose: This study aimed to investigate the relationship between dopamine receptor D2 (DRD2) and catechol-o-methyltransferase (COMT) gene polymorphism, hypothalamic-pituitary-thyroid (HPT) and hypothalamic-pituitary-gonadal (HPG) axes functions, and macroprolactinemia induced by antipsychotics.
Patients and Methods: A total of 133 patients with schizophrenia were selected and given risperidone (4~6mg/d) monotherapy. The polymorphisms of DRD2 Taq1A and COMT Val158Met were analyzed using RFLP-PCR at baseline, and the levels of total prolactin (T-PRL), macroprolactin, C peptide (C-P), estradiol (E2), cholesterol (TC), low density lipoprotein (LDL), insulin, cortisol, thyroid function, and reproductive hormone were measured at baseline and the end of the fourth week of treatment. The patients were divided into a hyperprolactinemia group and a macroprolactinemia group according to their levels of T-PRL and macroprolactin, and the differences in the above indexes between the two groups were analyzed.
Results: There was no significant difference in the DRD2 Taq1A or COMT Val158Met gene polymorphisms between the two groups. However, after four weeks of treatment, significant differences were observed between the two groups in terms of C-P (t= 2.16, p=0.04), E2 (t=− 3.89, p< 0.001), TC (t= − 2.54, p=0.01), insulin (t=− 3.93, p< 0.001), T3 (t= 2.31, p= 0.02), and FT3 (t=2.05, p=0.04).
Conclusion: DRD2 Taq1A and COMT Val158Met gene polymorphisms may not be effective in predicting macroprolactinemia, but changes in C-P, E2, TC, insulin, T3 and FT3 levels may have some suggestive significance for the differentiation of hyperprolactinemia and macroprolactinemia.

Keywords: prolactin, macroprolactin, hyperprolactinemia, schizophrenia, gene polymorphism