Department of Nephrology, OLVG west, Amsterdam, The Netherlands.
Department of Psychiatry, OLVG west, Amsterdam, The Netherlands.
Nephrol Dial Transplant. 2017 Jun 1;32(6):1040-1047. doi: 10.1093/ndt/gfw212.
Among chronic dialysis patients, associations have been found between inflammatory markers and depressive symptoms. In this population, no studies have examined the mechanism linking the association between inflammatory markers and depressive symptoms. We examined whether the association between inflammatory markers and depressive symptoms is mediated by tryptophan (TRP) degradation along the kynurenine (KYN) pathway.
The data are part of an observational, prospective cohort study in five urban dialysis centres in The Netherlands. Depressive symptoms were determined with the Beck Depression Inventory. Peripheral blood was collected before dialysis to measure inflammatory markers [high sensitivity C-reactive protein (HsCRP), interleukin (IL)-1β, IL-6, IL-10 and tumour necrosis factor-α (TNF-α)], TRP, KYN and 3-hydroxykynurenine. The KYN/TRP ratio was used as a measure of TRP degradation. The association between inflammatory markers and depressive symptoms was determined using linear regression analysis and adjusted for the KYN/TRP ratio.
In total, 490 chronic dialysis patients were included. HsCRP [ β = 3.8; confidence interval (CI): 1.0-6.6], IL-6 ( β = 9.1; CI: 4.0-14.1) and TNF-α ( β = 1.3; CI: 0.9-1.7) were associated with the KYN/TRP ratio. We found significant associations between HsCRP ( β = 0.8; CI: 0.3-1.3) and IL-6 ( β = 1.2; CI: 0.3-2.2) levels and depressive symptoms. However, this association was not attenuated after adjustment for the KYN/TRP ratio. Also, no significant associations were found between the KYN/TRP ratio and depressive symptoms.
The association between inflammatory markers and depressive symptoms in chronic dialysis patients was not mediated by TRP degradation along the KYN pathway.
在慢性透析患者中，炎症标志物与抑郁症状之间存在关联。在该人群中，尚无研究探讨炎症标志物与抑郁症状之间关联的机制。我们研究了炎症标志物与抑郁症状之间的关联是否通过色氨酸（TRP）沿着犬尿氨酸（KYN）途径降解来介导。
该数据来自荷兰五个城市透析中心的一项观察性、前瞻性队列研究。抑郁症状通过贝克抑郁量表进行评估。在透析前采集外周血以测量炎症标志物[高敏 C 反应蛋白（HsCRP）、白细胞介素（IL）-1β、IL-6、IL-10 和肿瘤坏死因子-α（TNF-α）]、TRP、KYN 和 3-羟基犬尿氨酸。KYN/TRP 比值用作 TRP 降解的衡量指标。使用线性回归分析确定炎症标志物与抑郁症状之间的关联，并对 KYN/TRP 比值进行调整。
共纳入 490 名慢性透析患者。HsCRP[β=3.8；置信区间（CI）：1.0-6.6]、IL-6（β=9.1；CI：4.0-14.1）和 TNF-α（β=1.3；CI：0.9-1.7）与 KYN/TRP 比值相关。我们发现 HsCRP（β=0.8；CI：0.3-1.3）和 IL-6（β=1.2；CI：0.3-2.2）水平与抑郁症状之间存在显著关联。然而，在调整 KYN/TRP 比值后，这种关联并未减弱。此外，KYN/TRP 比值与抑郁症状之间也没有显著关联。
在慢性透析患者中，炎症标志物与抑郁症状之间的关联并非由 KYN 途径中 TRP 降解介导。
