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老年重症抑郁症患者血清脂联素水平降低。

Reduced serum levels of adiponectin in elderly patients with major depression.

机构信息

Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.

出版信息

J Psychiatr Res. 2012 Aug;46(8):1081-5. doi: 10.1016/j.jpsychires.2012.04.028. Epub 2012 May 25.

DOI:10.1016/j.jpsychires.2012.04.028
PMID:22633396
Abstract

Recent studies have implicated adiponectin and other adipocytokines in brain function, particularly in processes related to memory and cognition. Blood levels of adiponectin are reduced in patients with primary cognitive disorders, such as Alzheimer's disease and mild cognitive impairment, and in adult patients with major depression. The aim of the present study is to determine serum levels of adiponectin in a sample of elderly patients with major depressive disorder (MDD) as compared to healthy older adults, and to examine the correlations between adiponectin levels and parameters indicative of mood and cognitive state. We recruited fifty-one unmedicated outpatients with late-life depression (LLD) and 47 age-matched controls in this study. The diagnosis of MDD was made according to the DSM-IV criteria, and the severity of depressive episode was determined with the 21-item Hamilton Depression Scale (HDRS). Cognitive state was ascertained with the Cambridge Cognitive Test (CAMCOG) and the Mini-Mental State Examination (MMSE). Serum concentrations of adiponectin were determined using a sandwich ELISA method. Serum levels of adiponectin were significantly reduced in individuals with LLD (F = p < 0.001). Adiponectin level remained significantly reduced in after controlling for BMI index, scores on the CAMCOG, MMSE and HDRS and educational level (p < 0.001). Adiponectin levels showed a negative correlation with HDRS scores (r = -0.59, p < 0.001) and BMI index (r = -0.42, p < 0.001); and showed a positive correlation with CAMCOG (r = 0.34, p < 0.01) and MMSE scores (r = 0.20, p = 0.05). The availability of circulating adiponectin is reduced in older adults with major depression, with likely implications on cognitive and mood state. Additional studies are required to determine whether this abnormality pertains to the pathophysiology of geriatric depression per se, or is a consequence of the morbid state.

摘要

最近的研究表明,脂联素和其他脂肪细胞因子与大脑功能有关,特别是与记忆和认知过程有关。在原发性认知障碍患者中,如阿尔茨海默病和轻度认知障碍患者以及成年重度抑郁症患者中,血液中的脂联素水平降低。本研究的目的是确定患有重度抑郁症(MDD)的老年患者与健康老年人的血清脂联素水平,并检查脂联素水平与提示情绪和认知状态的参数之间的相关性。我们在这项研究中招募了 51 名未经治疗的老年抑郁症(LLD)患者和 47 名年龄匹配的对照者。MDD 的诊断根据 DSM-IV 标准进行,抑郁发作的严重程度由 21 项汉密尔顿抑郁量表(HDRS)确定。认知状态通过剑桥认知测验(CAMCOG)和简易精神状态检查(MMSE)确定。脂联素的血清浓度采用夹心 ELISA 法测定。LLD 个体的血清脂联素水平显著降低(F= p <0.001)。在控制 BMI 指数、CAMCOG、MMSE 和 HDRS 评分以及教育程度后,脂联素水平仍显著降低(p <0.001)。脂联素水平与 HDRS 评分呈负相关(r=-0.59,p <0.001)和 BMI 指数(r=-0.42,p <0.001);与 CAMCOG 呈正相关(r=0.34,p <0.01)和 MMSE 评分(r=0.20,p=0.05)。患有重度抑郁症的老年人大脑中循环脂联素的含量降低,这可能对认知和情绪状态产生影响。需要进一步的研究来确定这种异常是否与老年抑郁症的病理生理学有关,或者是否是病态的结果。

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