Xu Ya-Yun, Liang Jun, Cao Yin, Shan Feng, Liu Yang, Xia Qing-Rong
Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, People's Republic of China.
Anhui Mental Health Center, Hefei, People's Republic of China.
Neuropsychiatr Dis Treat. 2017 Jun 23;13:1647-1653. doi: 10.2147/NDT.S138954. eCollection 2017.
Despite the increasing amount of evidence suggesting a relationship between depression and subclinical hypothyroidism (SCH), the exact mechanism underlying this relationship remains unclear. The main purpose of this study was to investigate the roles of plasma Nesfatin-1 levels and dysfunction of the hypothalamic-pituitary-adrenal (HPA) and hypothalamus-pituitary-thyroid (HPT) axes in the comorbidity of depression and SCH. Dysfunctions of the HPA and HPT axes were detected by measuring plasma corticosterone and thyroid-stimulating hormone (TSH) concentrations, respectively. Subjects in the patient group were selected from patients hospitalized at the Anhui Mental Health Center, and subjects in the control group were recruited from healthy volunteers. Healthy control subjects were matched to the patients in terms of weight and body mass index. The Hamilton Depression Rating Scale was administered to both the groups. The enzyme-linked immunosorbent assay method was used to measure plasma Nesfatin-1, corticosterone, and TSH levels. A radioimmunoassay kit was used for the measurement of the plasma-free triiodothyronine and plasma-free thyroxine. The results showed that the Hamilton Depression Rating Scale scores and average Nesfatin-1, corticosterone, and TSH levels were significantly higher in depressed patients with SCH than in the control group. Moreover, positive relationships were observed between Nesfatin-1 levels and the concentrations of corticosterone (=0.626, <0.001) and TSH (=0.229, =0.036) in depressed patients with SCH. These findings indicate that Nesfatin-1 is involved in the comorbidity of depression and SCH, and the mechanism underlying this involvement might be related to the dysfunction of the HPA and HPT axes.
尽管越来越多的证据表明抑郁症与亚临床甲状腺功能减退（SCH）之间存在关联，但这种关联背后的确切机制仍不清楚。本研究的主要目的是探讨血浆Nesfatin-1水平以及下丘脑-垂体-肾上腺（HPA）和下丘脑-垂体-甲状腺（HPT）轴功能障碍在抑郁症与SCH共病中的作用。分别通过测量血浆皮质酮和促甲状腺激素（TSH）浓度来检测HPA和HPT轴的功能障碍。患者组的受试者选自安徽精神卫生中心住院患者，对照组的受试者招募自健康志愿者。健康对照受试者在体重和体重指数方面与患者相匹配。两组均采用汉密尔顿抑郁量表进行评估。采用酶联免疫吸附测定法测量血浆Nesfatin-1、皮质酮和TSH水平。使用放射免疫分析试剂盒测量血浆游离三碘甲状腺原氨酸和血浆游离甲状腺素。结果显示，患有SCH的抑郁症患者的汉密尔顿抑郁量表评分以及平均Nesfatin-1、皮质酮和TSH水平显著高于对照组。此外，在患有SCH的抑郁症患者中，观察到Nesfatin-1水平与皮质酮浓度（=0.626，<0.001）和TSH浓度（=0.229，=0.036）之间呈正相关。这些发现表明，Nesfatin-1参与了抑郁症与SCH的共病，其潜在机制可能与HPA和HPT轴功能障碍有关。
