Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh.
Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh.
BMC Psychiatry. 2018 Apr 10;18(1):94. doi: 10.1186/s12888-018-1685-z.
Major depressive disorder (MDD) is a mixed disorder with the highly irregular course, inconsistent response to treatment and has no well-known mechanism for the pathophysiology. Major causes of depression are genetic, neurobiological, and environmental. However, over the past few years, altered serum levels of macro-minerals (MM) and trace elements (TE) have been recognized as major causative factors to the pathogenesis of many mental disorders. The purpose of this study was to determine the serum levels of MM (calcium and magnesium) and TE (copper, iron, manganese, selenium, and zinc) in MDD patients and find out their associations with depression risk.
This prospective case-control study recruited 247 patients and 248 healthy volunteers matched by age and sex. The serum levels of MM and TE were analyzed by atomic absorption spectroscopy (AAS). Statistical analysis was performed with independent sample t-tests and Pearson's correlation test.
We found significantly decreased concentrations of calcium and magnesium, iron, manganese, selenium, and zinc in MDD patients compared with control subjects (p < 0.05). But the concentration of copper was significantly increased in the patients than control subjects (p < 0.05). Data obtained from different inter-element relations in MDD patients and control subjects strongly suggest that there is a disturbance in the element homeostasis.
Our study suggests that altered serum concentrations of MM and TE are major contributing factors for the pathogenesis of MDD. Alterations of these elements in serum levels of MDD patients arise independently and they may provide a prognostic tool for the assessment of depression risk.
重度抑郁症(MDD)是一种混合性疾病,其病程高度不规则,对治疗反应不一致,且其病理生理学尚无明确机制。抑郁症的主要原因是遗传、神经生物学和环境因素。然而,在过去几年中,人们已经认识到血清中大、微量元素(MM 和 TE)水平的改变是许多精神障碍发病的主要原因。本研究旨在确定 MDD 患者的血清 MM(钙和镁)和 TE(铜、铁、锰、硒和锌)水平,并探讨其与抑郁风险的关系。
这项前瞻性病例对照研究招募了 247 名患者和 248 名年龄和性别相匹配的健康志愿者。采用原子吸收光谱法(AAS)分析 MM 和 TE 的血清水平。采用独立样本 t 检验和 Pearson 相关检验进行统计分析。
与对照组相比,MDD 患者的钙、镁、铁、锰、硒和锌浓度明显降低(p<0.05)。但患者组的铜浓度明显高于对照组(p<0.05)。从 MDD 患者和对照组中不同元素间关系获得的数据强烈表明,元素内稳态存在紊乱。
我们的研究表明,MM 和 TE 血清浓度的改变是 MDD 发病机制的主要因素。这些元素在 MDD 患者血清水平中的改变是独立发生的,它们可能为评估抑郁风险提供一种预后工具。