Costemale-Lacoste Jean-François, Trabado Séverine, Verstuyft Céline, El Asmar Khalil, Butlen-Ducuing Florence, Colle Romain, Ferreri Florian, Polosan Mircea, Haffen Emmanuel, Balkau Beverley, Falissard Bruno, Feve Bruno, Becquemont Laurent, Corruble Emmanuelle
INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France.
Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; INSERM 1185, Faculté de Medicine Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre 94275, France.
J Affect Disord. 2017 Aug 1;217:159-162. doi: 10.1016/j.jad.2017.04.011. Epub 2017 Apr 9.
Hypertriglyceridemia (HTG) is a cardiovascular risk factor. In the general population, elevated fasting triglyceridemia (TG) is associated with insomnia. Since insomnia is a core symptom of Major Depressive Episodes (MDE), we studied the association of severe insomnia with HTG in major depression.
We used the baseline data of the METADAP cohort, comprising 624 patients with a current MDE in a context of Major Depressive Disorder treated in psychiatry settings, without current alcohol use disorders. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterised by TG≥200mg/dL.
Severe insomnia was observed in 335(54%) patients with a current MDE, of whom 234(70%) were women; 49(8%) patients had HTG, of whom 25(51%) were women. 69(11%) patients were treated with lipid-lowering drugs. Severe insomnia was associated with a higher frequency of HTG in the whole sample (9.9% vs 5.6%, p=0.046) and in the subgroup of women (9.0% vs 2.0%, p=0.002). Multivariate logistic regression analyses adjusted for age, education levels, BMI and total HDRS scores confirmed the association between severe insomnia and HTG in the whole sample (OR=2.02, 95%CI [1.00-4.08], p=0.05) as well as in the subgroup of women (OR=4.82, 95%CI [1.5-15.5], p=0.008). No association was shown in men.
HTG should be systematically investigated in depressed patients with severe insomnia and particularly in women. Further studies are needed to explain the association we observed between severe insomnia and HTG.
高甘油三酯血症(HTG)是一种心血管危险因素。在普通人群中,空腹甘油三酯(TG)升高与失眠有关。由于失眠是重度抑郁发作(MDE)的核心症状,我们研究了重度失眠与重度抑郁症患者HTG之间的关联。
我们使用了METADAP队列的基线数据,该队列包括624名在精神病学环境中接受治疗的重度抑郁症患者,目前不存在酒精使用障碍。对患者进行重度失眠筛查,重度失眠定义为汉密尔顿抑郁量表(HDRS)睡眠项目得分达到4分或更高,同时筛查HTG,其特征为TG≥200mg/dL。
在335名(54%)目前患有MDE的患者中观察到重度失眠,其中234名(70%)为女性;49名(8%)患者患有HTG,其中25名(51%)为女性。69名(11%)患者接受了降脂药物治疗。在整个样本中(9.9%对5.6%,p=0.046)以及女性亚组中(9.0%对2.0%,p=0.002),重度失眠与HTG的发生率较高有关。在调整了年龄、教育水平、体重指数和HDRS总分的多因素逻辑回归分析中,证实了整个样本(比值比=2.02,95%置信区间[1.00-4.08],p=0.05)以及女性亚组(比值比=4.82,95%置信区间[1.5-15.5],p=0.008)中重度失眠与HTG之间的关联。在男性中未显示出关联。
对于患有重度失眠的抑郁症患者,尤其是女性,应系统地调查HTG。需要进一步研究来解释我们观察到的重度失眠与HTG之间的关联。