Genetic variants in dopamine pathways affect personality dimensions displayed by patients with eating disorders

We aimed to analyze the association between common polymorphisms in dopamine pathways with personality dimensions frequently present in patients with eating disorders (ED).

A total of 324 patients [210 with anorexia nervosa (AN), 80 with bulimia nervosa (BN) and 34 with binge-eating disorder (BED)] were diagnosed according to DSM-5 criteria and interviewed using the EDI 2 and SCL-90R questionnaires at the eating disorders unit. Blood samples were drawn and the DNA screened for polymorphisms in dopamine receptor genes (DRD2 A2/A1 and DRD3 Ser9Gly) and in the dopamine transporter DAT1 10R/9R.

AN patients who carried the DRD3 Gly9Gly genotype displayed significantly higher EDI-2 total scores than patients with the Ser9 allele (118.09 ± 8.75 vs. 97.23 ± 2.73, p = 0.010). In these patients, Gly9Gly carriers also showed higher scores in all the individuals' EDI-2 scales. Differences were especially relevant for bulimia (p = 0.004), ineffectiveness (p = 0.044), interpersonal distrust (p = 0.037), interoceptive awareness (p = 0.006) and maturity fears (p = 0.038). Epistasis analyses showed a strong effect of the interaction between DRD3 Ser9Gly and DRD2 A2A1 on the bulimia (p < 0.05), ineffectiveness (p < 0.05) and asceticism (p < 0.01) scales, as well as on the EDI-2 total score (p < 0.05). The scores of the SCL-90R inventory were largely unaffected by the presence of the polymorphisms.

Whilst no associations were found for the BN and BED groups, our results suggest that women with AN carrying the homozygous variant Gly9Gly genotype in the dopamine D3 receptor have significantly worse ED-related symptomatology.

Level III (evidence obtained from well-designed cohort or case-control analytic studies).