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在重度抑郁症中,焦虑的严重程度(而非抑郁的严重程度)与氧化应激相关。

Severity of anxiety- but not depression- is associated with oxidative stress in Major Depressive Disorder.

作者信息

Steenkamp Lisa R, Hough Christina M, Reus Victor I, Jain Felipe A, Epel Elissa S, James S Jill, Morford Alexandra E, Mellon Synthia H, Wolkowitz Owen M, Lindqvist Daniel

机构信息

Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, United States; Institute of Psychology, Leiden University, Leiden, The Netherlands.

Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, United States.

出版信息

J Affect Disord. 2017 Sep;219:193-200. doi: 10.1016/j.jad.2017.04.042. Epub 2017 May 6.

Abstract

BACKGROUND

Oxidative stress is implicated in both depression and anxiety, but it is currently unclear whether this relates to syndromal diagnoses or trans-diagnostic dimensional symptoms. We examined the relationship between oxidative stress and severity of depression and anxiety symptoms in individuals with Major Depressive Disorder (MDD).

METHODS

Plasma oxidative stress markers F2-isoprostanes and oxidized glutathione (GSSG), and the antioxidant reduced glutathione (GSH), were assessed in 69 physically healthy, medication-free MDD subjects. Symptoms of anxiety and depression were assessed using the Hamilton Anxiety (HAM-A) and Hamilton Depression (HAM-D) Rating Scales. Total HAM-A and HAM-D scores, along with "core" anxiety and depression subscales, and individual HAM-D items "psychic anxiety" and "depressed mood," were related to oxidative stress markers. Analyses controlled for age, sex, BMI, and smoking.

RESULTS

Total HAM-A ratings were positively associated with F2-isoprostanes (β=.26, p=.042) and GSSG (β=.25, p=.049), but not GSH (β=.05, p=.711). Core anxiety severity was positively associated with F2-isoprostanes (β=.34, p=.012) and GSSG, although this did not reach significance (β=.24, p=.074). None of the biological markers were significantly associated with total HAM-D or core depression ratings (all p>.13). Subjects scoring high on "psychic anxiety" had elevated F2-isoprostanes (p=.030) and GSSG (p=.020). This was not seen with "depressed mood" scores (all p>.12).

LIMITATIONS

We assessed peripheral oxidative markers, but their relationship to the brain is unclear.

CONCLUSIONS

Oxidative stress is more closely related to anxiety than depression symptoms in MDD. This highlights the importance of relating oxidative stress to specific symptoms and could provide new insights into the biological correlates of affective disorders.

摘要

背景

氧化应激与抑郁症和焦虑症均有关联,但目前尚不清楚这是否与综合征诊断或跨诊断维度症状有关。我们研究了重度抑郁症(MDD)患者氧化应激与抑郁和焦虑症状严重程度之间的关系。

方法

对69名身体健康、未服用药物的MDD患者进行血浆氧化应激标志物F2-异前列腺素和氧化型谷胱甘肽(GSSG)以及抗氧化剂还原型谷胱甘肽(GSH)的评估。使用汉密尔顿焦虑量表(HAM-A)和汉密尔顿抑郁量表(HAM-D)评估焦虑和抑郁症状。HAM-A和HAM-D总分,以及“核心”焦虑和抑郁子量表,以及HAM-D单项“精神性焦虑”和“抑郁情绪”,均与氧化应激标志物相关。分析对年龄、性别、体重指数和吸烟进行了控制。

结果

HAM-A总评分与F2-异前列腺素(β = 0.26,p = 0.042)和GSSG(β = 0.25,p = 0.049)呈正相关,但与GSH无关(β = 0.05,p = 0.711)。核心焦虑严重程度与F2-异前列腺素(β = 0.34,p = 0.012)和GSSG呈正相关,尽管未达到显著水平(β = 0.24,p = 0.074)。没有一种生物标志物与HAM-D总分或核心抑郁评分显著相关(所有p>0.13)。“精神性焦虑”得分高的受试者F2-异前列腺素(p = 0.030)和GSSG(p = 0.020)升高。“抑郁情绪”得分则未出现这种情况(所有p>0.12)。

局限性

我们评估的是外周氧化标志物,但其与大脑的关系尚不清楚。

结论

在MDD中,氧化应激与焦虑症状的关系比与抑郁症状的关系更为密切。这凸显了将氧化应激与特定症状联系起来的重要性,并可能为情感障碍的生物学相关性提供新的见解。

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