Department of Nephrology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Ren Fail. 2013 Sep;35(8):1094-100. doi: 10.3109/0886022X.2013.817257. Epub 2013 Jul 23.
The aim of this study is to evaluate depression and anxiety scores among chronic kidney disease (CKD) patients and to search the changes of serum concentrations of adipokines with respect to emotional disturbances of CKD patients.
150 patients recruited into this cross-sectional analytic study. Study groups were control, hemodialysis, predialysis, peritoneal dialysis and kidney transplantation groups. Fasting morning serum leptin, ghrelin, acylated ghrelin, neuropeptide Y, adiponectin, resistin levels of all of the groups were measured using ELISA (Sandwich) method. A screening interview based on the Structured Clinical Interview for DSM-IV and self-report scales (The Beck Depression [BDI] and The Beck Anxiety Inventory [BAI] and Brief Symptom Inventory [BSI] which is self report scales) were administered and conducted by a trained interviewer.
BDI scores were significantly higher in hemodialysis and predialysis groups compared to control group (p = 0.009). Somatization sub scores of BSI were significantly higher in hemodialysis and peritoneal dialysis groups compared to control group (p = 0.041). Also positive symptom distress index scores of BSI were significantly higher in hemodialysis and transplantation groups compared to control group (p = 0.047). BDI score were significantly negatively correlated with duration of education (r = -0.165, p = 0.045), positively correlated with presence of protein energy wasting (r = 0.198, p = 0.016), and resistin levels (r = 0.233, p = 0.004).
CKD patients had higher BDI, BSI-somatization, BSI-positive symptom distress index scores compared to control group. High serum resistin levels, presence of protein energy wasting might have a role in development of depressive disorders of patients with chronic kidney disease.
本研究旨在评估慢性肾脏病（CKD）患者的抑郁和焦虑评分，并探讨血清脂联素浓度的变化与 CKD 患者情绪障碍的关系。
本横断面分析研究纳入 150 例患者。研究组包括对照组、血液透析组、透析前组、腹膜透析组和肾移植组。采用酶联免疫吸附法（夹心法）检测所有组别的空腹晨血清瘦素、胃饥饿素、酰化胃饥饿素、神经肽 Y、脂联素、抵抗素水平。由经过培训的访谈者进行基于 DSM-IV 结构化临床访谈和自我报告量表（贝克抑郁量表[BDI]、贝克焦虑量表[BAI]和简明症状量表[BSI]，为自我报告量表）的筛查访谈。
与对照组相比，血液透析组和透析前组的 BDI 评分显著升高（p=0.009）。BSI 的躯体化子量表评分在血液透析组和腹膜透析组中明显高于对照组（p=0.041）。BSI 的阳性症状困扰指数评分在血液透析组和移植组中也明显高于对照组（p=0.047）。BDI 评分与受教育时间呈显著负相关（r=-0.165，p=0.045），与蛋白能量消耗的存在呈显著正相关（r=0.198，p=0.016），与抵抗素水平呈显著正相关（r=0.233，p=0.004）。
与对照组相比，CKD 患者的 BDI、BSI-躯体化、BSI-阳性症状困扰指数评分更高。高血清抵抗素水平、存在蛋白能量消耗可能与慢性肾脏病患者抑郁障碍的发生有关。
