Department of Nephrology, A. Fleming General Hospital, Athens, Greece.
Am J Nephrol. 2010;31(4):303-8. doi: 10.1159/000285110. Epub 2010 Feb 13.
BACKGROUND/AIMS: Depression represents the most frequent psychiatric disorder in nephrology. Cytokines, and especially IL-6, were found to be elevated in depressed patients with normal renal function. The objective of this pilot study was to examine the relationship between depression and cytokines (IL-6, TNF-alpha, and IL-10) in patients with end-stage kidney disease (ESKD).
We studied 44 stable patients with ESKD for 71 +/- 66 months (32 males; 64 +/- 13 years; 27 on hemodialysis and 17 on peritoneal dialysis). The control group included 20 healthy age- and gender-matched individuals (12 males; 60 +/- 12 years). Depression was assessed by the Zung Self-Rating Depression Scale (ZS). Nephelometry for high-sensitivity CRP and ELISA kits for IL-6, IL-10 and TNF-alpha were used.
Compared to controls, patients with ESKD had higher ZS scores (56.8 +/- 16.8 vs. 44 +/- 12.7, p < 0.01), WBC (7,987 +/- 2,347 vs. 6,413 +/- 870/mm(3), p < 0.01), ESR (36.3 +/- 15.8 vs. 9.4 +/- 3.3 mm, p < 0.001), TNF-alpha (52 +/- 18.4 vs. 10.7 +/- 2.8 pg/ml, p < 0.001) and IL-6 (6.3 +/- 4 vs. 1.8 +/- 0.4 pg/ml, p < 0.001). No differences in high-sensitivity CRP and IL-10 were noted between the ESKD and control groups. Serum IL-6 levels were the only parameter positively correlated with the values of the ZS score in ESKD patients (r = 0.34, p < 0.02).
IL-6 may play a role in the pathogenesis of depression in patients with ESKD.
背景/目的：抑郁是肾病学中最常见的精神疾病。研究发现，在肾功能正常的抑郁患者中，细胞因子，特别是白细胞介素 6（IL-6）升高。本研究的目的是研究终末期肾病（ESKD）患者的抑郁与细胞因子（IL-6、TNF-α和 IL-10）之间的关系。
我们研究了 44 例稳定的 ESKD 患者，随访时间为 71 ± 66 个月（32 名男性；64 ± 13 岁；27 名血液透析患者和 17 名腹膜透析患者）。对照组包括 20 名年龄和性别匹配的健康个体（12 名男性；60 ± 12 岁）。使用zung 自评抑郁量表（ZS）评估抑郁。采用比浊法测定高敏 C 反应蛋白，酶联免疫吸附试验（ELISA）试剂盒测定 IL-6、IL-10 和 TNF-α。
与对照组相比，ESKD 患者的 ZS 评分更高（56.8 ± 16.8 vs. 44 ± 12.7，p < 0.01），白细胞计数（7987 ± 2347 vs. 6413 ± 870/mm3，p < 0.01），红细胞沉降率（36.3 ± 15.8 vs. 9.4 ± 3.3 mm，p < 0.001），TNF-α（52 ± 18.4 vs. 10.7 ± 2.8 pg/ml，p < 0.001）和 IL-6（6.3 ± 4 vs. 1.8 ± 0.4 pg/ml，p < 0.001）。ESKD 组和对照组之间的高敏 C 反应蛋白和 IL-10 无差异。ESKD 患者中，血清 IL-6 水平与 ZS 评分呈正相关（r = 0.34，p < 0.02）。
IL-6 可能在 ESKD 患者抑郁的发病机制中起作用。
