Insulin 투여후 정신분열병환자의 혈장 Growth Hormone 및 Homovanillic Acid 농도의 변화

Changes of Plasma Growth Hormone and Homovanillic Acid Concentration after Insulin Administration in Patients with Schizophrenia

The authors examined the changes of plasma level of growth hormone(GH) and homovanillic acid(HVA) after insulin administration in schizophrenic patients and control subjects. Fifteen neuroleptics-taking patients and eight healthy control subjects participated in a study of insulin- induced dopaminergic perturbation, with multiple samples for plasma HVA and GH at baseline, 60min and 90min after insulin administration. Regular insulin(0.1 unit/kg) caused a significant decrease of glucose level and increase of GH level after 60min in both normal controls and schizophrenic patients. We did not find significant difference of GH concentrations at baseline, 60min and 90min between normal subjects and patients with schizophrenia. In schizophrenic subjects there was an inverse relationship between age of onset and GH level at 90min point. The GH level of patients whose first age of onset was more than 26 years was quitely low. There appeared a bimodal distribution of GH level at 90min in schizophrenic patients. The clinical characteristics of the patients with higher GH level(more than 20ng/ml) were long duration of illness(more than 12 years) and old age(more than 37 years old). There was a significant difference of HVA level at baseline between normal control subjects and schizophrenic patients. This pattern was not associated with clinical variables, such as age, age of onset, duration of illness and presence of family history. Schizophrenic patients were grouped by the positive and negative syndrome scale. The positive group had higher HVA level at baseline than negative group. The HVA concentrations of normal control subjects and positive group decreased significantly after insulin administration, but there was no decrease in negative group. These results suggest that plasma HVA concentration may be associated with the different dopaminergic alterations of heterogeneous schizophrenia. The GH and HVA level after insulin administration could be used as indices for the delineation of complex clinical manifestations of schizophrenia