Karaoulanis Sokratis E, Rizouli Katerina A, Rizoulis Andreas A, Angelopoulos Nikiforos V
Department of Psychiatry, University Hospital of Larissa, University of Thessalia, Mezourlo, Larissa, P,O, Box 41110, Greece.
BMC Psychiatry. 2014 Jun 4;14:164. doi: 10.1186/1471-244X-14-164.
Major depression is associated with higher plasma levels of positive acute-phase proteins, as well as with lower plasma levels of negative acute-phase proteins. The aim of this study is to examine the levels of acute-phase response proteins and whether these levels are influenced by reproductive hormones and antidepressant medication in the perimenopausal depression.
Sixty-five women (age range: 40-58 years old) participated in this study. All women were in the perimenopausal phase. The diagnosis of depression was made through a psychiatric interview and with the aid of Hamilton Depression Rating Scale 17 (HAM-D 17). The acute-phase response proteins, such as haptoglobin (HP), transferrine (TRf), α1-antitrypsin, complement protein 3 (C3), complement protein 4 (C4) and C-reactive protein (CRP) and the reproductive hormones, for example follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), were analyzed using standard laboratory methods. Pearson's correlations were applied to evaluate the relationship between acute-phase proteins and hormones.
Perimenopausal women were divided into three groups. The first group consisted of normal controls, the second one involved depressed perimenopausal women, who were taking selective serotonin reuptake inhibitors (SSRIs), and the third one included depressed women that were not treated with SSRIs. Depressed women in perimenopause, when being compared to non-depressed women, did not differ as to serum levels of acute-phase proteins. There was a positive correlation between HP and E2 in depressed perimenopausal women, who were not taking SSRIs.
The lack of association between acute-phase proteins and depressive mood mentioned in this study does not support previous findings in patients with major depression. This negative finding in perimenopausal depression indicates either the absence or a more complex nature of the interactions between acute-phase proteins, low-grade inflammation and depression. The hormonal profile of women is a part of this complexity, because it seems that in perimenopause the hormonal changes are accompanied by changes of acute-phase response proteins. Particularly, in perimenopausal depression, there is an interaction between HP and E2. Therefore, it seems that perimenopause is a period of a woman's life during which hormonal, immune and metabolic changes occur and interact with each other making women vulnerable to depression.
重度抑郁症与血浆中阳性急性期蛋白水平升高以及阴性急性期蛋白水平降低有关。本研究的目的是检测围绝经期抑郁症患者急性期反应蛋白的水平，以及这些水平是否受生殖激素和抗抑郁药物的影响。
65名女性（年龄范围：40 - 58岁）参与了本研究。所有女性均处于围绝经期。通过精神科访谈并借助汉密尔顿抑郁量表17项（HAM - D 17）进行抑郁症诊断。采用标准实验室方法分析急性期反应蛋白，如触珠蛋白（HP）、转铁蛋白（TRf）、α1 - 抗胰蛋白酶、补体蛋白3（C3）、补体蛋白4（C4）和C反应蛋白（CRP），以及生殖激素，如促卵泡激素（FSH）、黄体生成素（LH）和雌二醇（E2）。应用Pearson相关性分析来评估急性期蛋白与激素之间的关系。
围绝经期女性分为三组。第一组为正常对照组，第二组为正在服用选择性5 - 羟色胺再摄取抑制剂（SSRI）的围绝经期抑郁症女性，第三组为未接受SSRI治疗的抑郁症女性。与未患抑郁症的女性相比，围绝经期抑郁症女性的急性期蛋白血清水平并无差异。在未服用SSRI的围绝经期抑郁症女性中，HP与E2之间存在正相关。
本研究中提到的急性期蛋白与抑郁情绪之间缺乏关联，这与先前重度抑郁症患者的研究结果不符。围绝经期抑郁症的这一阴性结果表明，急性期蛋白、低度炎症与抑郁症之间的相互作用要么不存在，要么具有更复杂的性质。女性的激素状况是这种复杂性的一部分，因为在围绝经期，激素变化似乎伴随着急性期反应蛋白的变化。特别是在围绝经期抑郁症中，HP与E2之间存在相互作用。因此，围绝经期似乎是女性生命中的一个时期，在此期间激素、免疫和代谢变化相互发生并相互作用，使女性易患抑郁症。
