中重度临床稳定期 COPD 患者全身炎症、抑郁和疲劳的生物标志物。
Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD.
机构信息
University of Manchester, Manchester Academic Health Sciences Centre, University Hospital of South Manchester Foundation Trust, Wythenshawe, Manchester, UK.
出版信息
Respir Res. 2011 Jan 5;12(1):3. doi: 10.1186/1465-9921-12-3.
INTRODUCTION
COPD is an inflammatory disease with major co-morbidities. It has recently been suggested that depression may be the result of systemic inflammation. We aimed to explore the association between systemic inflammation and symptoms of depression and fatigue in patients with mainly moderate and clinically stable COPD using a range of inflammatory biomarkers, 2 depression and 2 fatigue scales.
METHOD
We assessed 120 patients with moderate COPD (FEV1% 52, men 62%, age 66). Depression was assessed using the BASDEC and CES-D scales. Fatigue was assessed using the Manchester COPD-fatigue scale (MCFS) and the Borg scale before and after 6MWT. We measured systemic TNF-α, CRP, TNF-α-R1, TNF-α-R2 and IL-6.
RESULTS
A multivariate linear model of all biomarkers showed that TNF-α only had a positive correlation with BASDEC depression score (p = 0.007). TNF-α remained positively correlated with depression (p = 0.024) after further adjusting for TNF-α-R1, TNF-α-R2, 6MWD, FEV1%, and pack-years. Even after adding the MCFS score, body mass and body composition to the model TNF-α was still associated with the BASDEC score (p = 0.044). Furthermore, patients with higher TNF-α level (> 3 pg/ml, n = 7) had higher mean CES-D depression score than the rest of the sample (p = 0.03). Borg fatigue score at baseline were weakly correlated with TNF-α and CRP, and with TNF-α only after 6MWT. Patients with higher TNF-α had more fatigue after 6MWD (p = 0.054).
CONCLUSION
This study indicates a possible association between TNF-α and two frequent and major co-morbidities in COPD; i.e., depression and fatigue.
简介
COPD 是一种炎症性疾病，伴有多种合并症。最近有人提出，抑郁可能是全身炎症的结果。我们旨在使用一系列炎症生物标志物，2 种抑郁量表和 2 种疲劳量表，探讨主要为中度和临床稳定的 COPD 患者全身炎症与抑郁和疲劳症状之间的关系。
方法
我们评估了 120 名中度 COPD 患者（FEV1% 52%，男性 62%，年龄 66 岁）。使用 BASDEC 和 CES-D 量表评估抑郁。使用 Manchester COPD-fatigue 量表（MCFS）和 Borg 量表在 6MWT 前后评估疲劳。我们测量了全身 TNF-α、CRP、TNF-α-R1、TNF-α-R2 和 IL-6。
结果
所有生物标志物的多元线性模型显示，TNF-α 仅与 BASDEC 抑郁评分呈正相关（p = 0.007）。TNF-α 与抑郁仍呈正相关（p = 0.024），进一步调整 TNF-α-R1、TNF-α-R2、6MWD、FEV1%和吸烟包年数后。即使在向模型中添加 MCFS 评分、体重和身体成分后，TNF-α 仍与 BASDEC 评分相关（p = 0.044）。此外，TNF-α 水平较高（>3pg/ml，n = 7）的患者 CES-D 抑郁评分均值高于样本其余部分（p = 0.03）。基线时 Borg 疲劳评分与 TNF-α 和 CRP 呈弱相关，仅在 6MWT 后与 TNF-α 相关。TNF-α 较高的患者在 6MWD 后疲劳感更强烈（p = 0.054）。
结论
本研究表明 TNF-α 与 COPD 两种常见且主要的合并症（即抑郁和疲劳）之间可能存在关联。
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