Martinac Marko, Babić Dragan, Bevanda Milenko, Vasilj Ivan, Glibo Danijela Bevanda, Karlović Dalibor, Jakovljević Miro
Mostar Center for Mental Health, Mostar Health Center, Hrvatskih branitelja bb, 88 000 Mostar, Bosnia and Herzegovina,
Psychiatr Danub. 2017 Mar;29(1):39-50.
The aim of the present study was to explore the differences in serum CRP, IL-6, TNF-α, ACTH and cortisol among patients with major depressive disorder with or without metabolic syndrome (MS) compared to a healthy control group.
The MDD study group consisted of 80 patients (mean age of 50.03±9.55 years). The control group was recruited from the hospital personnel and it consisted of 40 examinees (mean age of 47.20±7.99 years). All patients who participated in the study were diagnosed with depressive disorder using MINI questionnaire, and Hamilton rating scale for depression. Diagnosis of the metabolic syndrome was set by NCEP ATP III criteria.
Examinees with depression but without MS had significantly more cortisol concentration when compared to the control group. CRP was significantly higher in the MDD group when compared to the control group and in MDD+MS group when compared to the control group. IL6 serum levels were significantly higher in the MDD group when compared to the healthy control group, and in MDD+MS group when compared to the healthy control group. ACTH had significant independent predictive values for abdominal obesity. Levels of TNF-α were statistically significant independent predictors for hyperglycaemia. Statistically significant predictive values for MDD were found for cortisol, and IL-6.
Results shown here emphasise the importance of neuroendocrine and inflammatory factors in pathogenesis of depressive disorder and MS. Further prospective research is necessary to clarify possible causal relationship between depression and MS. It is necessary to investigate the possibility of a joint biological mechanism in pathogenesis of these two disorders with the special attention given to the disturbances in the immune system.
本研究旨在探讨伴或不伴代谢综合征（MS）的重度抑郁症患者与健康对照组相比，血清中CRP、IL-6、TNF-α、促肾上腺皮质激素（ACTH）和皮质醇的差异。
重度抑郁症研究组由80例患者组成（平均年龄50.03±9.55岁）。对照组从医院工作人员中招募，由40名受试者组成（平均年龄47.20±7.99岁）。所有参与研究的患者均使用MINI问卷和汉密尔顿抑郁量表诊断为抑郁症。代谢综合征的诊断依据美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP III）标准。
与对照组相比，患有抑郁症但无MS的受试者皮质醇浓度显著更高。与对照组相比，重度抑郁症组的CRP显著更高，与对照组相比，重度抑郁症+代谢综合征组的CRP也显著更高。与健康对照组相比，重度抑郁症组的IL-6血清水平显著更高，与健康对照组相比，重度抑郁症+代谢综合征组的IL-6血清水平也显著更高。促肾上腺皮质激素对腹型肥胖具有显著的独立预测价值。TNF-α水平是高血糖的统计学显著独立预测因素。皮质醇和IL-6对重度抑郁症具有统计学显著的预测价值。
此处所示结果强调了神经内分泌和炎症因子在抑郁症和代谢综合征发病机制中的重要性。有必要进行进一步的前瞻性研究以阐明抑郁症与代谢综合征之间可能的因果关系。有必要研究这两种疾病发病机制中联合生物学机制的可能性，并特别关注免疫系统的紊乱。
