不同亚型抑郁症年轻男性的胰岛素敏感性、促炎标志物和脂联素

Insulin sensitivity, proinflammatory markers and adiponectin in young males with different subtypes of depressive disorder.

作者信息

Hung Yi-Jen, Hsieh Chang-Hsun, Chen Yu-Jun, Pei Dee, Kuo Shi-Wen, Shen Der-Chung, Sheu Wayne Huey-Herng, Chen Yi-Chyan

机构信息

Division of Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Clin Endocrinol (Oxf). 2007 Nov;67(5):784-9. doi: 10.1111/j.1365-2265.2007.02963.x. Epub 2007 Aug 13.

DOI:10.1111/j.1365-2265.2007.02963.x

PMID:17697007

Abstract

OBJECTIVE

This study was designed to evaluate insulin sensitivity, proinflammatory markers and adiponectin concentration in young males with different subtypes of depressive disorder.

METHODS

Nonobese young males with depressive disorder (ages between 18 years and 30 years; body mass index, BMI < or = 25 kg/m(2)) were recruited and divided into reactive depression (RD, N = 14), major depression (MD, N = 21) and bipolar depression (BD, N = 15) based on clinical course and symptom changes in Hamilton rating scale for depression (HAM-D). Fourteen age- and BMI-matched healthy males were enrolled as controls. All of the participants received a 75-g oral glucose tolerance test (OGTT). Insulin sensitivity and beta-cell function were calculated by minimal model method from the frequently sampled intravenous glucose tolerance test. Plasma C-reactive protein (CRP), adiponectin, tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were determined.

RESULTS

Compared to the controls, insulin sensitivity (S(I)) were significantly lower in MD and BD (0.78 +/- 0.09 min(-1)/pmol and 0.75 +/- 0.09 min(-1)/pmol vs. 1.09 +/- 0.08 x 10(-5) min(-1)/pmol, P < 0.05, respectively). Acute insulin response (AIR) to intravenous glucose was elevated in BD as compared to control and RD groups (6079.9 +/- 841.8 pmol vs. 3339.8 +/- 356.4 pmol and 3494.8 +/- 337.7 pmol, P < 0.05, respectively). Plasma adiponectin level was diminished in BD group as compared to the control and RD groups (7.41 +/- 0.45 microg/ml vs. 9.07 +/- 0.54 microg/ml and 9.38 +/- 0.46 microg/ml; P < 0.05 and P < 0.01, respectively). By regression analysis, a significantly negative correlation between HAM-D score and S(I) was found in MD (r = -0.60, P = 0.005) and BD groups (r = -0.57, P = 0.04).

CONCLUSIONS

The results suggest that there is an inverse relationship between both major and bipolar depression and insulin resistance in nonobese young males.

摘要

目的

本研究旨在评估不同亚型抑郁症青年男性的胰岛素敏感性、促炎标志物和脂联素浓度。

方法

招募非肥胖抑郁症青年男性（年龄在18岁至30岁之间；体重指数，BMI≤25kg/m²），根据抑郁症汉密尔顿评定量表（HAM-D）的临床病程和症状变化分为反应性抑郁症（RD，N = 14）、重度抑郁症（MD，N = 21）和双相抑郁症（BD，N = 15）。选取14名年龄和BMI匹配的健康男性作为对照。所有参与者均接受75g口服葡萄糖耐量试验（OGTT）。通过频繁采样静脉葡萄糖耐量试验的最小模型法计算胰岛素敏感性和β细胞功能。测定血浆C反应蛋白（CRP）、脂联素以及肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）。

结果

与对照组相比，MD组和BD组的胰岛素敏感性（S(I)）显著降低（分别为0.78±0.09min⁻¹/pmol和0.75±0.09min⁻¹/pmol，而对照组为1.09±0.08×10⁻⁵min⁻¹/pmol，P<0.05）。与对照组和RD组相比，BD组对静脉注射葡萄糖的急性胰岛素反应（AIR）升高（分别为6079.9±841.8pmol vs. 3339.8±356.4pmol和3494.8±337.7pmol，P<0.05）。与对照组和RD组相比，BD组血浆脂联素水平降低（分别为7.41±0.45μg/ml vs. 9.07±0.54μg/ml和9.38±0.46μg/ml；P<0.05和P<0.01）。通过回归分析，发现MD组（r = -0.60，P = 0.005）和BD组（r = -0.57，P = 0.04）的HAM-D评分与S(I)之间存在显著负相关。