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抑郁发作患者烟酸皮肤潮红反应与非酶抗氧化物及甲状腺激素的相关性研究
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Abstract:
目的:探讨抑郁发作患者在非酶类抗氧化物、甲状腺激素以及烟酸皮肤潮红反应(Niacin skin flushing response, NSFR)等方面的异常表现,并分析这些生物标志物之间的相关性及其与患者临床症状改善的关系。方法:纳入2023年6月至2024年6月在青岛市精神卫生中心住院治疗的100例抑郁发作患者(患者组),同期于周围社区招募了50名健康志愿者(对照组),其中52名患者完成了8周的随访。采用汉密尔顿抑郁量表17项(Hamilton depression scale-17, HAMD-17)、汉密尔顿焦虑量表(Hamilton anxiety scale, HAMA)评估临床症状;采用烟酸潮红皮肤反应分析仪对受试者进行NSFR测试并分析评分;同时测定非酶类抗氧化物包括尿酸(Uric Acid, UA)、白蛋白(Albumin, ALB)和胆红素(Bilirubin, BIL)水平,甲状腺激素包括促甲状腺激素(Thyroid-Stimulating Hormone, TSH)和甲状腺激素,如游离三碘甲状腺原氨酸(Free Triiodothyronine, FT3)和游离四碘甲状腺原氨酸(Free Thyroxine, FT4)水平。结果:患者组相较于对照组,FT4、TSH水平显著升高,FT3水平明显降低;UA水平显著升高;NSFR得分显著降低。患者组非酶类抗氧化物与甲状腺激素之间存在显著关联,如ALB与UA、FT3及FT4呈正相关,BIL与FT4和TSH正相关;FT3与TSH呈负相关,FT4与TSH呈正相关。患者组基线NSFR、非酶类抗氧化物及甲状腺激素与临床症状改善之间无显著相关。结论:本研究发现抑郁症患者在非酶类抗氧化物、甲状腺激素以及NSFR等方面存在显著异常,且这些生物标志物之间存在复杂关联,提示抑郁发作患者存在氧化应激水平及甲状腺功能的异常。基线生物标志物与临床症状改善之间未能得到阳性相关性,提示抑郁症的病理生理机制可能涉及多种因素。
Objective: To explore the abnormal manifestations of non-enzymatic antioxidants, thyroid hormones, and niacin skin flushing response (NSFR) in patients with depressive episodes, and to analyze the correlations among these biomarkers and their relationship with the improvement of clinical symptoms. Methods: A total of 100 patients with depressive episodes hospitalized at Qingdao Mental Health Center from June 2023 to June 2024 were enrolled as the patient group, and 50 healthy volunteers were recruited from the surrounding community during the same period as the control group. Among them, 52 patients completed an 8-week follow-up. Clinical symptoms were assessed using the Hamilton Depression Scale-17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA). The NSFR test was conducted on participants using a niacin skin flushing response analyzer and scored accordingly. Simultaneously, levels of non-enzymatic antioxidants, including uric acid (UA), albumin (ALB), and bilirubin (BIL), as well as thyroid hormones, including thyroid-stimulating hormone (TSH) and thyroid hormones such as free triiodothyronine (FT3) and free thyroxine (FT4), were measured. Results: Compared with the control group, the patient group exhibited significantly higher levels of FT4 and TSH, but significantly lower levels of FT3; UA levels were significantly elevated; and NSFR scores were significantly reduced. Significant correlations were observed between non-enzymatic antioxidants and thyroid hormones in the patient group, such as positive correlations of ALB with UA, FT3, and FT4, and of BIL with FT4 and
[1] | Li, M., Gao, W., Zhang, Y., Luo, Q., Xiang, Y., Bao, K., et al. (2023) Secular Trends in the Incidence of Major Depressive Disorder and Dysthymia in China from 1990 to 2019. BMC Public Health, 23, Article No. 2162. https://doi.org/10.1186/s12889-023-17025-4 |
[2] | Malhi, G.S. and Mann, J.J. (2018) Depression. The Lancet, 392, 2299-2312. https://doi.org/10.1016/s0140-6736(18)31948-2 |
[3] | 郅珂, 蒋婕, 高志勤. 烟酸皮肤反应在精神分裂症中的研究进展[J]. 国际精神病学杂志, 2023, 50(4): 586-588+599. |
[4] | 黄东, 刘少文. 氧化应激与精神分裂症的研究现况[J]. 国际精神病学杂志, 2018, 45(2): 208-210. |
[5] | Bode, H., Ivens, B., Bschor, T., Schwarzer, G., Henssler, J. and Baethge, C. (2021) Association of Hypothyroidism and Clinical Depression: A Systematic Review and Meta-Analysis. JAMA Psychiatry, 78, Article No. 1375. https://doi.org/10.1001/jamapsychiatry.2021.2506 |
[6] | 刘福坤, 李立华, 范长河. 首发抑郁症患者抗抑郁治疗前后甲状腺功能的变化[J]. 广东医学, 2013, 34(3): 371-374. |
[7] | Chaudhari, K., Khanzode, S., Khanzode, S., Dakhale, G., Saoji, A. and Sarode, S. (2010) Clinical Correlation of Alteration of Endogenous Antioxidant-Uric Acid Level in Major Depressive Disorder. Indian Journal of Clinical Biochemistry, 25, 77-81. https://doi.org/10.1007/s12291-010-0016-z |
[8] | Chueire, V.B., Brito Silva, E.T., Perotta, E., Romaldini, J.H. and Ward, L.S. (2003) High Serum TSH Levels Are Associated with Depression in the Elderly. Archives of Gerontology and Geriatrics, 36, 281-288. https://doi.org/10.1016/s0167-4943(02)00173-5 |
[9] | Kumar, R., LeMahieu, A.M., Stan, M.N., Seshadri, A., Ozerdem, A., Pazdernik, V.K., et al. (2023) The Association between Thyroid Stimulating Hormone and Depression: A Historical Cohort Study. Mayo Clinic Proceedings, 98, 1009-1020. https://doi.org/10.1016/j.mayocp.2022.12.020 |
[10] | Zhou, Y., Ma, Y., Wu, Q., Wang, Q., Yang, W.F.Z., Wang, Y., et al. (2021) Comparison of Thyroid Hormone Levels between Patients with Major Depressive Disorder and Healthy Individuals in China. Frontiers in Psychiatry, 12, Article ID: 750749. https://doi.org/10.3389/fpsyt.2021.750749 |
[11] | Mokrani, M., Duval, F., Erb, A., Gonzalez Lopera, F. and Danila, V. (2020) Are the Thyroid and Adrenal System Alterations Linked in Depression? Psychoneuroendocrinology, 122, Article ID: 104831. https://doi.org/10.1016/j.psyneuen.2020.104831 |
[12] | Black, C.N., Bot, M., Scheffer, P.G., Snieder, H. and Penninx, B.W.J.H. (2018) Uric Acid in Major Depressive and Anxiety Disorders. Journal of Affective Disorders, 225, 684-690. https://doi.org/10.1016/j.jad.2017.09.003 |
[13] | Drulović, J., Dujmović, I., Stojsavljević, N., Mesaroš, Š., Andjelković, S., Miljković, D., et al. (2001) Uric Acid Levels in Sera from Patients with Multiple Sclerosis. Journal of Neurology, 248, 121-126. https://doi.org/10.1007/s004150170246 |
[14] | Bosveld-van Haandel, L., Knegtering, R., Kluiter, H. and van den Bosch, R.J. (2006) Niacin Skin Flushing in Schizophrenic and Depressed Patients and Healthy Controls. Psychiatry Research, 143, 303-306. https://doi.org/10.1016/j.psychres.2005.10.010 |
[15] | Bai, Z., Bo, A., Wu, S., Gai, Q. and Chi, I. (2018) Omega-3 Polyunsaturated Fatty Acids and Reduction of Depressive Symptoms in Older Adults: A Systematic Review and Meta-Analysis. Journal of Affective Disorders, 241, 241-248. https://doi.org/10.1016/j.jad.2018.07.057 |
[16] | Jia, R., Yuan, X., Zhang, X., Song, P., Han, S., Wang, S., et al. (2023) Oxidative Stress Impairs Cognitive Function by Affecting Hippocampal Fimbria Volume in Drug-Naïve, First-Episode Schizophrenia. Frontiers in Neuroscience, 17, Article ID: 1153439. https://doi.org/10.3389/fnins.2023.1153439 |
[17] | Su, Q., Li, T., He, P., Lu, X., Yu, Q., Gao, Q., et al. (2021) Trichostatin a Ameliorates Alzheimer’s Disease-Related Pathology and Cognitive Deficits by Increasing Albumin Expression and Aβ Clearance in APP/PS1 Mice. Alzheimer’s Research & Therapy, 13, Article No. 7. https://doi.org/10.1186/s13195-020-00746-8 |
[18] | Fischer, S. and Ehlert, U. (2017) Hypothalamic-Pituitary-Thyroid (HPT) Axis Functioning in Anxiety Disorders. A Systematic Review. Depression and Anxiety, 35, 98-110. https://doi.org/10.1002/da.22692 |
[19] | 廖宇, 张世蕾, 王宇. 以甲状腺毒性周期性麻痹为首发表现的垂体促甲状腺细胞腺瘤: 1例报告[J]. 复旦学报(医学版), 2023, 50(6): 935-938. |
[20] | 俞放, 赵咏桔, 陈瑛, 等. 甲状腺激素受体β基因V458A点突变所致甲状腺激素抵抗综合征[J]. 中华内分泌代谢杂志, 2004(4): 311-313. |
[21] | Gine-Serven, E., Martinez-Ramirez, M., Boix-Quintana, E., Davi-Loscos, E., Guanyabens, N., Casado, V., et al. (2023) Association between Free Thyroxine Levels and Clinical Phenotype in First-Episode Psychosis: A Prospective Observational Study. PeerJ, 11, e15347. https://doi.org/10.7717/peerj.15347 |
[22] | Song, L., Zhou, H., Yang, Q., He, N., Fu, F., Li, W., et al. (2024) Association between the Oxidative Balance Score and Thyroid Function: Results from the NHANES 2007-2012 and Mendelian Randomization Study. PLOS ONE, 19, e0298860. https://doi.org/10.1371/journal.pone.0298860 |
[23] | Sun, L., Yang, X., Jiang, J., Hu, X., Qing, Y., Wang, D., et al. (2017) Identification of the Niacin-Blunted Subgroup of Schizophrenia Patients from Mood Disorders and Healthy Individuals in Chinese Population. Schizophrenia Bulletin, 44, 896-907. https://doi.org/10.1093/schbul/sbx150 |
[24] | Hasselbalch, B.J., Knorr, U., Hasselbalch, S.G., Gade, A. and Kessing, L.V. (2013) The Cumulative Load of Depressive Illness Is Associated with Cognitive Function in the Remitted State of Unipolar Depressive Disorder. European Psychiatry, 28, 349-355. https://doi.org/10.1016/j.eurpsy.2012.03.004 |
[25] | Sarandol, A., Sarandol, E., Eker, S.S., Erdinc, S., Vatansever, E. and Kirli, S. (2007) Major Depressive Disorder Is Accompanied with Oxidative Stress: Short‐Term Antidepressant Treatment Does Not Alter Oxidative-Antioxidative Systems. Human Psychopharmacology: Clinical and Experimental, 22, 67-73. https://doi.org/10.1002/hup.829 |
[26] | 赵迎新, 陈允恩. 烟酸皮肤潮红反应用于抑郁症诊断的相关研究(综述) [J]. 中国健康心理学杂志, 2024, 32(4): 503-509. |