Kahl Kai G, Schweiger Ulrich, Pars Kaweh, Kunikowska Alicja, Deuschle Michael, Gutberlet Marcel, Lichtinghagen Ralf, Bleich Stefan, Hüper Katja, Hartung Dagmar
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany.
Department of Psychiatry and Psychotherapy, University of Lubeck, Lubeck, Germany.
Psychoneuroendocrinology. 2015 Aug;58:1-8. doi: 10.1016/j.psyneuen.2015.04.008. Epub 2015 Apr 20.
Major depressive disorder (MDD) is associated with an increased risk for the development of cardio-metabolic diseases. Increased intra-abdominal (IAT) and pericardial adipose tissue (PAT) have been found in depression, and are discussed as potential mediating factors. IAT and PAT are thought to be the result of a dysregulation of the hypothalamus-pituitary-adrenal axis (HPAA) with subsequent hypercortisolism. Therefore we examined adrenal gland volume as proxy marker for HPAA activation, and IAT and PAT in depressed patients. Twenty-seven depressed patients and 19 comparison subjects were included in this case-control study. Adrenal gland volume, pericardial, intraabdominal and subcutaneous adipose tissue were measured by magnetic resonance imaging. Further parameters included factors of the metabolic syndrome, fasting cortisol, fasting insulin, and proinflammatory cytokines. Adrenal gland and pericardial adipose tissue volumes, serum concentrations of cortisol and insulin, and serum concentrations tumor-necrosis factor-α were increased in depressed patients. Adrenal gland volume was positively correlated with intra-abdominal and pericardial adipose tissue, but not with subcutaneous adipose tissue. Our findings point to the role of HPAA dysregulation and hypercortisolism as potential mediators of IAT and PAT enlargement. Further studies are warranted to examine whether certain subtypes of depression are more prone to cardio-metabolic diseases.
重度抑郁症（MDD）与发生心脏代谢疾病的风险增加相关。抑郁症患者的腹内脂肪组织（IAT）和心包脂肪组织（PAT）增加，它们被视为潜在的中介因素进行讨论。IAT和PAT被认为是下丘脑 - 垂体 - 肾上腺轴（HPAA）失调及随后的高皮质醇血症的结果。因此，我们研究了抑郁症患者的肾上腺体积作为HPAA激活的替代标志物以及IAT和PAT。本病例对照研究纳入了27名抑郁症患者和19名对照受试者。通过磁共振成像测量肾上腺体积、心包、腹内和皮下脂肪组织。其他参数包括代谢综合征因素、空腹皮质醇、空腹胰岛素和促炎细胞因子。抑郁症患者的肾上腺和心包脂肪组织体积、皮质醇和胰岛素的血清浓度以及肿瘤坏死因子-α的血清浓度均升高。肾上腺体积与腹内和心包脂肪组织呈正相关，但与皮下脂肪组织无关。我们的研究结果表明，HPAA失调和高皮质醇血症作为IAT和PAT增大的潜在介质发挥作用。有必要进行进一步研究，以检查某些抑郁症亚型是否更容易患心脏代谢疾病。
