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女性的抑郁症状与脂肪因子:全国妇女健康研究。

Depressive symptoms and adipokines in women: Study of women's health across the nation.

机构信息

Department of Medicine and Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, United States.

Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States.

出版信息

Psychoneuroendocrinology. 2018 Nov;97:20-27. doi: 10.1016/j.psyneuen.2018.07.011. Epub 2018 Jul 5.

Abstract

Small clinical studies suggest depression is associated with alterations in adiponectin and leptin, adipocyte-derived secretory proteins involved in metabolic regulation; however, longitudinal data on these association are lacking. This study examined cross-sectional and longitudinal associations of depressive symptoms and major depressive disorder (MDD) with adiponectin and leptin in healthy middle-aged women (mean (SD) age, 45.6 (2.5) years). Cross-sectional analyses included 575 women with baseline adipokine data; longitudinal analyses included 262 women with 2-4 adipokine measurements over 5 years. The 20-item Center for Epidemiologic Studies Depression scale (CES-D) was used to assess depressive symptoms; history of MDD was determined by the Structured Clinical Interview for DSM-IV. Adipokines were assayed from stored serum specimens; values were log-transformed for analyses. Linear and repeated measure random effects regression models evaluated associations of baseline CES-D scores with baseline adipokine concentrations and changes over time, respectively. Secondary analyses evaluated the relation of MDD history with adipokine concentrations. Mean (SD) baseline concentrations of adiponectin and leptin were 9.90 (4.92) μg/mL and 27.02 (20.06) ng/mL; both increased over time (p < .0001). CES-D scores were associated with lower adiponectin at baseline (per 1-SD: estimate=-0.04, SE=.02, p=.03) and over time (per 1-SD: estimate=-0.055, SE = .024, p=.02). Associations were unchanged in risk factor-adjusted models. Women with elevated CES-D scores (≥16) had 6.9% (95% CI: -1.1%, 14.3%; p = .089) lower median adiponectin at baseline and 11.5% (95% CI: 1.5%, 20.4%, p = .025) lower median adiponectin over time in adjusted models, compared to women with CES-D<16. Rate of change in adipokines did not vary by baseline depressive symptoms or MDD history. Depressive symptoms and MDD history were unrelated to leptin. In women at midlife, depressive symptoms are associated with lower adiponectin, a critical anti-inflammatory biomarker involved in metabolic and cardiovascular conditions.

摘要

小型临床研究表明,抑郁症与脂联素和瘦素的改变有关,脂联素和瘦素是参与代谢调节的脂肪细胞衍生的分泌蛋白;然而,缺乏这些关联的纵向数据。本研究在健康中年女性(平均(SD)年龄,45.6(2.5)岁)中,检查了抑郁症状和重度抑郁症(MDD)与脂联素和瘦素的横断面和纵向关联。横断面分析包括 575 名基线有脂联素数据的女性;纵向分析包括 262 名在 5 年内进行了 2-4 次脂联素测量的女性。使用 20 项流行病学研究中心抑郁量表(CES-D)评估抑郁症状;通过 DSM-IV 结构化临床访谈确定 MDD 病史。从储存的血清标本中检测脂联素;为了分析,值被对数转换。线性和重复测量随机效应回归模型分别评估了基线 CES-D 评分与基线脂联素浓度和随时间变化的关联。次要分析评估了 MDD 病史与脂联素浓度的关系。脂联素和瘦素的基线平均(SD)浓度分别为 9.90(4.92)μg/ml 和 27.02(20.06)ng/ml;两者随时间推移均增加(p<0.0001)。CES-D 评分与基线时较低的脂联素相关(每 1-SD:估计值=-0.04,SE=0.02,p=0.03)和随时间变化(每 1-SD:估计值=-0.055,SE=0.024,p=0.02)。在危险因素调整模型中,关联保持不变。CES-D 评分较高(≥16)的女性在调整模型中,基线时的中位数脂联素降低了 6.9%(95%CI:-1.1%,14.3%;p=0.089),随时间变化时的中位数脂联素降低了 11.5%(95%CI:1.5%,20.4%,p=0.025),而 CES-D<16 的女性则没有。脂联素的变化率与基线抑郁症状或 MDD 病史无关。抑郁症状和 MDD 病史与瘦素无关。在中年女性中,抑郁症状与较低的脂联素有关,脂联素是一种参与代谢和心血管疾病的关键抗炎生物标志物。

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