Meyer Thomas, Chavanon Mira-Lynn, Herrrmann-Lingen Christoph, Roggenthien Maren, Nolte Kathleen, Pieske Burkert, Wachter Rolf, Edelmann Frank
Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Göttingen, Germany; German Centre for Cardiovascular Research, partner site Göttingen, Göttingen, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Göttingen, Germany.
PLoS One. 2015 Aug 31;10(8):e0136739. doi: 10.1371/journal.pone.0136739. eCollection 2015.
The role of endothelin-1 (ET-1) in the neurobiology of anxiety is unknown, therefore, we assessed in the observational multicenter DIAST-CHF study whether the C-terminal ET-1 precursor fragment (CT-proET-1) is linked to anxiety.
Plasma concentrations of CT-proET-1 were measured in a total of 1,410 patients presenting with cardiovascular risk factors (mean age 66.91±8.2 years, 49.3% males, mean left ventricular ejection fraction 60.0±8.2%) who had completed the Hospital Anxiety and Depression Scale (HADS) questionnaire.
Among the total study cohort (n = 1,410), there were 118 subjects (8.4%) with an HADS anxiety score above the cut-off level of 11 suggestive of clinically relevant anxiety. Plasma CT-proET-1 levels were significantly lower in the group of anxious patients as compared to non-anxious patients (p = 0.013). In regression models adjusted for sex, age, systolic blood pressure, and diameters of left atrium and ventricle, plasma CT-proET-1 was again linked to anxiety (Exp(β) = 0.247, 95%-confidence interval [95%-CI] = 0.067-0.914, p = 0.036). Given the high prevalence of depressive disorders in anxious patients, we additionally included the HADS depression score as an independent variable in the models and found that CT-proET-1 remained a significant predictor of anxiety, independent of comorbid depression (Exp(β) = 0.114, 95%-CI = 0.023-0.566, p = 0.008).
Our data from a population-based study in outpatients with cardiovascular risk factors revealed that circulating CT-proET-1 levels are negatively associated with anxiety. Further investigations are required to clarify the putative anxiolytic effect of ET-1 or its precursor molecules in humans and to decipher its mechanistic pathways.
内皮素-1（ET-1）在焦虑神经生物学中的作用尚不清楚，因此，我们在多中心观察性DIAST-CHF研究中评估了C末端ET-1前体片段（CT-proET-1）是否与焦虑有关。
对总共1410例有心血管危险因素的患者（平均年龄66.91±8.2岁，男性占49.3%，平均左心室射血分数60.0±8.2%）进行血浆CT-proET-1浓度测定，这些患者均完成了医院焦虑抑郁量表（HADS）问卷调查。
在整个研究队列（n = 1410）中，有118名受试者（8.4%）的HADS焦虑评分高于提示临床相关焦虑的临界值11分。与非焦虑患者相比，焦虑患者组的血浆CT-proET-1水平显著降低（p = 0.013）。在对性别、年龄、收缩压以及左心房和心室直径进行校正的回归模型中，血浆CT-proET-1再次与焦虑有关（Exp(β)= 0.247，95%置信区间[95%-CI]= 0.067 - 0.914，p = 0.036）。鉴于焦虑患者中抑郁症的高患病率，我们在模型中额外纳入了HADS抑郁评分作为自变量，发现CT-proET-1仍然是焦虑的显著预测因子，独立于共病抑郁症（Exp(β)= 0.114，95%-CI = 0.023 - 0.566，p = 0.008）。
我们在有心血管危险因素的门诊患者中进行的基于人群的研究数据显示，循环CT-proET-1水平与焦虑呈负相关。需要进一步研究以阐明ET-1或其前体分子在人类中的假定抗焦虑作用，并破译其作用机制途径。
