Veronese Nicola, De Rui Marina, Bolzetta Francesco, Zambon Sabina, Corti Maria Chiara, Baggio Giovannella, Toffanello Elena Debora, Crepaldi Gaetano, Perissinotto Egle, Manzato Enzo, Sergi Giuseppe
Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy.
Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy.
Am J Geriatr Psychiatry. 2015 Aug;23(8):863-71. doi: 10.1016/j.jagp.2014.10.009. Epub 2014 Nov 6.
Dehydroepiandrosterone sulfate (DHEAS) appears to have a protective effect against depression, but contrasting findings are available. Therefore, we investigated whether high serum DHEAS levels were associated with any protective effect on incident depression and incident severe depression in a representative group of elderly men and women.
In a population-based cohort longitudinal study in the general community, 789 older participants without depression and cognitive impairment at the baseline were included, among 3,099 screened subjects. Serum DHEAS levels were determined based on blood samples; incident depression and severe depression were diagnosed by means of the Geriatric Depression Scale (GDS) and confirmed by geriatricians skilled in psychogeriatric medicine.
No baseline differences were found in GDS across age- and gender-specific tertiles of serum DHEAS. Over 4.4 years of follow-up, 137 new cases of depression were recorded. Of them, 35 among men and 64 in women were cases of incident severe depression. Cox's regression analysis, adjusted for potential confounders, revealed that higher DHEAS levels were associated with reduced risk of incident depression irrespective of gender (HR: 0.30; 95% CI: 0.09-0.96; Wald χ(2) = 4.09; df = 1; p = 0.04; women: HR: 0.31; 95% CI: 0.14-0.69; Wald χ(2) = 8.37; df = 1; p = 0.004) and of severe incident depression only in men (HR: 0.25; 95% CI: 0.06-0.99; Wald χ(2) = 4.05; df = 1; p = 0.04).
Higher serum DHEAS levels were found to be significantly protective for the onset of depression irrespective of gender, whereas only in men was this association found also for incident severe depression.
硫酸脱氢表雄酮（DHEAS）似乎对抑郁症具有保护作用，但也有相反的研究结果。因此，我们调查了在一组具有代表性的老年男性和女性中，血清DHEAS水平升高是否与对新发抑郁症和新发重度抑郁症具有任何保护作用相关。
在一项基于社区人群的队列纵向研究中，从3099名筛查对象中纳入了789名在基线时无抑郁症和认知障碍的老年参与者。根据血样测定血清DHEAS水平；新发抑郁症和重度抑郁症通过老年抑郁量表（GDS）进行诊断，并由精通老年精神病学的老年科医生确诊。
在血清DHEAS的年龄和性别特异性三分位数中，GDS在基线时未发现差异。在4.4年的随访中，记录了137例新发抑郁症病例。其中，男性35例，女性64例为新发重度抑郁症病例。在对潜在混杂因素进行调整的Cox回归分析中，结果显示，较高的DHEAS水平与新发抑郁症风险降低相关，与性别无关（风险比：0.30；95%置信区间：0.09 - 0.96；Wald χ² = 4.09；自由度 = 1；p = 0.04；女性：风险比：0.31；95%置信区间：0.14 - 0.69；Wald χ² = 8.37；自由度 = 1；p = 0.004），且仅在男性中与新发重度抑郁症相关（风险比：0.25；95%置信区间：0.06 - 0.99；Wald χ² = 4.05；自由度 = 1；p = 0.04）。
发现较高的血清DHEAS水平对抑郁症的发病具有显著的保护作用，与性别无关，而仅在男性中发现这种关联也适用于新发重度抑郁症。
