Department of Medical Engineering and Biotechnology, University of Applied Sciences, Jena, Germany.
Prog Neuropsychopharmacol Biol Psychiatry. 2011 Jun 1;35(4):1131-8. doi: 10.1016/j.pnpbp.2011.03.015. Epub 2011 Mar 29.
Depression has been shown to increase the risk for cardiovascular disease (CVD) more strongly in women than in men. Although the underlying mechanisms are unknown, a putative role of increased sympathetic modulation has been suggested for the association of CVD and depression. The aim of this study was to investigate possible gender-associated differences of autonomic function in healthy volunteers and patients suffering from major depressive disorder (MDD). Linear as well as non-linear measures of heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were obtained in each 18 male and 18 female unmedicated patients and respective control subjects. Gender differences were detectable in healthy subjects showing predominant sympathetic modulation in males. This was most obvious in BPV analysis. These gender differences were abolished in patients suffering from MDD, mainly due to altered autonomic modulation in female patients. Our results indicate that BPV is more sensitive to reveal depression-associated changes of autonomic function as compared to HRV. Moreover, female patients contribute most to the overall difference between patients and controls. The shift in the balance of autonomic function in women might account for the increased prevalence of CVD in these patients.
抑郁已被证明在女性中比男性更能增加心血管疾病（CVD）的风险。尽管其潜在机制尚不清楚，但交感神经调节增加被认为与 CVD 和抑郁有关。本研究旨在探讨健康志愿者和患有重度抑郁症（MDD）的患者自主功能中可能存在的性别相关差异。在每位 18 名男性和 18 名女性未接受药物治疗的患者和相应的对照组中，获得了心率变异性（HRV）、血压变异性（BPV）和压力反射敏感性（BRS）的线性和非线性测量值。在健康受试者中可以检测到性别差异，男性主要表现为交感神经调节。这在 BPV 分析中最为明显。这些性别差异在患有 MDD 的患者中消失，主要是由于女性患者自主神经调节改变。我们的研究结果表明，与 HRV 相比，BPV 更能敏感地揭示与抑郁相关的自主功能变化。此外，女性患者对患者和对照组之间的总体差异贡献最大。女性自主功能平衡的转变可能是这些患者 CVD 患病率增加的原因。
