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炎症相关生物标志物与近期诊断为 1 型和 2 型糖尿病个体抑郁症状之间的关联。

Associations between inflammation-related biomarkers and depressive symptoms in individuals with recently diagnosed type 1 and type 2 diabetes.

机构信息

Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraβe 1, 85764 München-Neuherberg, Germany.

German Center for Diabetes Research (DZD), Ingolstädter Landstraβe 1, 85764 München-Neuherberg, Germany; Paul Langerhans Group for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany.

出版信息

Brain Behav Immun. 2017 Mar;61:137-145. doi: 10.1016/j.bbi.2016.12.025. Epub 2016 Dec 29.

Abstract

Depressive disorders represent a frequent comorbidity of both type 1 (T1D) and type 2 diabetes (T2D). Inflammation-related processes have been implicated in the development of both diabetes and depression. This study aimed to investigate whether biomarkers of subclinical inflammation were associated with depressive symptoms in individuals with recently diagnosed diabetes and if such associations differed by diabetes type. This cross-sectional study was based on 295 individuals with T2D (67% men, mean age 53years) and 139 individuals with T1D (60% men, mean age 36years) of the German Diabetes Study. The main inclusion criterion was a known disease duration of <1year. Depressive symptoms were assessed with the Allgemeine Depressionsskala, Langversion (ADS-L) questionnaire, the German version of the Center for Epidemiological Studies Depression scale (CES-D) questionnaire. Associations between biomarkers of subclinical inflammation and the ADS-L as continuous score were assessed using multiple linear regression models adjusting for age, sex, body mass index, HbA1c, lipids, hypertension, medication and comorbidities. Serum high-sensitivity C-reactive protein (hsCRP) and the ratio of high-molecular-weight (HMW)/total adiponectin were positively associated with ADS-L in T2D (both P<0.01), but not in T1D. In contrast, serum levels of soluble intercellular adhesion molecule (sICAM)-1 were positively associated with ADS-L only in T1D (P=0.035). The latter association was significantly different between both diabetes types (P=0.036). No associations were observed for interleukin (IL)-6, IL-18 and soluble E-selectin. Only the association between HMW/total adiponectin and ADS-L in T2D remained significant after correction for multiple testing. In conclusion, our study shows that the ratio HMW/total adiponectin is associated with depressive symptoms in individuals with recently diagnosed T2D. It also provides suggestive evidence that further biomarkers of subclinical inflammation and endothelial activation may be associated with depressive symptoms in individuals with recently diagnosed T1D and T2D.

摘要

抑郁障碍是 1 型(T1D)和 2 型糖尿病(T2D)的常见共病。炎症相关过程与糖尿病和抑郁症的发生有关。本研究旨在探讨亚临床炎症的生物标志物是否与近期诊断为糖尿病的个体的抑郁症状相关,以及这些关联是否因糖尿病类型而异。这项横断面研究基于德国糖尿病研究中的 295 名 T2D 患者(67%为男性,平均年龄为 53 岁)和 139 名 T1D 患者(60%为男性,平均年龄为 36 岁)。主要纳入标准是已知的疾病病程<1 年。抑郁症状采用一般抑郁量表(ADS-L)问卷、德国版流行病学研究抑郁量表(CES-D)问卷进行评估。使用多元线性回归模型,在调整年龄、性别、体重指数、HbA1c、血脂、高血压、药物治疗和合并症后,评估亚临床炎症生物标志物与 ADS-L 连续评分之间的关系。在 T2D 中,血清高敏 C 反应蛋白(hsCRP)和高分子量(HMW)/总脂联素的比值与 ADS-L 呈正相关(均 P<0.01),但在 T1D 中无相关性。相反,血清可溶性细胞间黏附分子(sICAM)-1 水平仅与 T1D 中的 ADS-L 呈正相关(P=0.035)。这种关联在两种糖尿病类型之间存在显著差异(P=0.036)。IL-6、IL-18 和可溶性 E-选择素与 ADS-L 之间无相关性。只有 T2D 中 HMW/总脂联素与 ADS-L 之间的关联在经过多次测试校正后仍具有统计学意义。总之,本研究表明,HMW/总脂联素的比值与近期诊断为 T2D 的个体的抑郁症状相关。它还提供了提示性证据,表明亚临床炎症和内皮激活的其他生物标志物可能与近期诊断为 T1D 和 T2D 的个体的抑郁症状相关。

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