Changchien Te-Chang, Tai Chi-Ming, Huang Chih-Kun, Chien Chia-Chang, Yen Yung-Chieh
Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan.
Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
Neuropsychiatr Dis Treat. 2015 Aug 19;11:2153-8. doi: 10.2147/NDT.S88075. eCollection 2015.
There is a significant relationship between obesity and common mental symptoms (depression and anxiety symptoms). But the association between depression (or anxiety symptoms) and serum leptin is still unclear and controversial, despite the growing body of evidence supporting the existence of "leptin resistance" in obese persons. So we investigated whether common mental symptoms, obesity, and the interactive effect of these two factors have a relationship with leptin in obese patients who were candidates for bariatric surgery.
In all, 139 participants (mean age: 31.4 years, standard deviation: 9.3 years, 73.4% female) were enrolled at an obesity treatment center in southern Taiwan. Serum leptin levels and body mass index (BMI) were measured. The Chinese Health Questionnaire and Taiwanese Depression Questionnaire were administered.
The mean BMI of our participants was 39.4 kg/m(2) (±6.8), and the mean leptin level was 24.5 ng/mL (±9.4). In the multivariate regression models, Chinese Health Questionnaire-by-BMI and Taiwanese Depression Questionnaire-by-BMI interaction terms remained significant predictors of leptin level (β=0.16, P<0.0001; β=0.04, P<0.0001, respectively), after adjustment for age, sex, and history of hypertension, diabetes, and hyperlipidemia, despite the inverse correlation between Chinese Health Questionnaire (or Taiwanese Depression Questionnaire) and leptin. In addition, female patients had significantly higher leptin levels than male patients.
The present findings confirmed that the relationship between common mental symptoms and leptin is modulated by obesity in severely obese patients. Future studies should focus on further measures of leptin receptors or signaling on the basis of these interactive effects in psychiatry.
肥胖与常见精神症状（抑郁和焦虑症状）之间存在显著关联。尽管越来越多的证据支持肥胖者存在“瘦素抵抗”，但抑郁（或焦虑症状）与血清瘦素之间的关联仍不明确且存在争议。因此，我们调查了常见精神症状、肥胖以及这两个因素的交互作用与接受减肥手术的肥胖患者瘦素之间是否存在关系。
总共139名参与者（平均年龄：31.4岁，标准差：9.3岁，73.4%为女性）在台湾南部的一个肥胖治疗中心入组。测量血清瘦素水平和体重指数（BMI）。使用了中国健康问卷和台湾抑郁问卷。
我们参与者的平均BMI为39.4 kg/m²（±6.8），平均瘦素水平为24.5 ng/mL（±9.4）。在多变量回归模型中，尽管中国健康问卷（或台湾抑郁问卷）与瘦素呈负相关，但在调整年龄、性别以及高血压、糖尿病和高脂血症病史后，中国健康问卷与BMI的交互项以及台湾抑郁问卷与BMI的交互项仍然是瘦素水平的显著预测因素（β = 0.16，P < 0.0001；β = 0.04，P < 0.0001）。此外，女性患者的瘦素水平显著高于男性患者。
目前的研究结果证实，在严重肥胖患者中，常见精神症状与瘦素之间的关系受肥胖调节。未来的研究应基于这些在精神病学中的交互作用，进一步关注瘦素受体或信号传导的测量。
