Chen Chunfeng, Gao Jingfang, Zhang Junjie, Jia Liying, Yu Tugen, Zheng Yizhi
Department of Mental Health, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.
Department of Scientific Research Management, Zhejiang Chinese Medical University, Hangzhou, China.
Arch Womens Ment Health. 2016 Dec;19(6):1001-1008. doi: 10.1007/s00737-016-0647-z. Epub 2016 Jun 13.
The aim of this study was to assess the possible relationship between leptin status and postpartum depressive symptoms using serum levels of leptin collected 24-48 h after delivery in a cohort Chinese sample. Women delivering a full-term, singleton, and live-born infant in the period from August 2013 to March 2014 were enrolled immediately postpartum. A blood sample was obtained 24-48 h after childbirth to test serum levels of leptin. Participation consisted of a visit in an obstetric unit at 3 months after delivery. The Edinburgh Postnatal Depression Scale (EPDS), completed at 3 months postpartum, was used to classify each woman's depression symptom severity. Demographic, obstetric, behavioral risk, mental health, and psychosocial factors were considered. Multiple logistic regression analyses were used to identify risk factors most predictive of postpartum depressive symptoms. During the study period, 407 individuals were included and completed follow-up. At 3 months, according to EPDS score, 53 women (13.0 %) were considered as postpartum depressive symptoms. Serum leptin levels in women with PPD were significantly greater than those in women without depressive symptoms (36.5 [IQR, 25.5-50.4] vs. 14.5 [IQR, 9.4-22.4] ng/ml, P < 0.0001). Based on the ROC curve, the optimal cutoff value of serum leptin levels as an indicator for predicting of depressive symptoms was projected to be 24.3 ng/mL, which yielded a sensitivity of 88.7 % and a specificity of 73.4 %, with the area under the curve at 0.867 (95 % CI, 0.817-0.916). In multivariate analysis, there was an increased risk of depressive symptoms associated with leptin levels ≥24.3 ng/ml (OR 8.234; 95 % CI, 3.572-15.876; P < 0.0001) after adjusting for possible confounders. Elevated serum leptin levels at delivery could eventually serve as a biological marker for the prediction of depressive symptoms. These associations were independent of other possible variables.
本研究旨在通过对一组中国样本在分娩后24 - 48小时采集的血清瘦素水平进行检测，评估瘦素状态与产后抑郁症状之间的可能关系。2013年8月至2014年3月期间分娩足月、单胎、活产婴儿的妇女在产后立即被纳入研究。在分娩后24 - 48小时采集血样以检测血清瘦素水平。研究还包括在产后3个月时到产科病房进行一次访视。使用产后3个月完成的爱丁堡产后抑郁量表（EPDS）对每位女性的抑郁症状严重程度进行分类。研究考虑了人口统计学、产科、行为风险、心理健康和社会心理因素。采用多元逻辑回归分析来确定最能预测产后抑郁症状的风险因素。在研究期间，407人被纳入并完成随访。在产后3个月时，根据EPDS评分，53名女性（13.0%）被认为有产后抑郁症状。产后抑郁女性的血清瘦素水平显著高于无抑郁症状的女性（36.5 [四分位间距，25.5 - 50.4] 对比 14.5 [四分位间距，9.4 - 22.4] ng/ml，P < 0.0001）。基于ROC曲线，预测抑郁症状的血清瘦素水平的最佳截断值预计为24.3 ng/mL，其敏感性为88.7%，特异性为73.4%，曲线下面积为0.867（95%可信区间，0.817 - 0.916）。在多变量分析中，在调整可能的混杂因素后，瘦素水平≥24.3 ng/ml与抑郁症状风险增加相关（比值比8.234；95%可信区间，3.572 - 15.876；P < 0.0001）。分娩时血清瘦素水平升高最终可能作为预测抑郁症状的生物学标志物。这些关联独立于其他可能的变量。
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