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在一项肥胖患者的横断面研究中,有重大抑郁病史与神经精神症状相关,但与系统性炎症无关。

History of major depression is associated with neuropsychiatric symptoms but not systemic inflammation in a cross-sectional study in obese patients.

机构信息

INRA, Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, 33076 Bordeaux, France; University of Bordeaux, Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, 33076 Bordeaux, France; Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, Spain; Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain.

INRA, Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, 33076 Bordeaux, France; University of Bordeaux, Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, 33076 Bordeaux, France.

出版信息

Brain Behav Immun. 2019 Feb;76:215-222. doi: 10.1016/j.bbi.2018.11.312. Epub 2018 Nov 23.

Abstract

Obesity is a major public health burden associated with neuropsychiatric comorbidities leading to social and occupational impairment. Given the growing prevalence of both obesity and mental disorders worldwide, understanding the risk factors of obesity-related neuropsychiatric comorbidities is crucial to develop preventive strategies and individualized treatments. Recent findings suggest that adiposity-driven inflammation contributes to neuropsychiatric comorbidities in obesity. However, not all obese subjects afflicted with chronic inflammation develop neuropsychiatric symptoms, suggesting additional risk factors. The aim of this study was to investigate the impact of personal history of major depressive disorder (MDD) on obesity-related inflammation and neuropsychiatric symptoms, and their relationship. A case-control study was conducted comparing 66 obese patients (body mass index > 35 kg/m) and 22 healthy non-obese participants, free of any current neuropsychiatric diseases including MDD. Neuropsychiatric symptoms were assessed using the Neurotoxicity Rating Scale (NRS). Sociodemographic and clinical variables were gathered and blood was collected for the measurement of serum levels of high-sensitivity C-reactive protein (hs-CRP). Multiple regression analyses were performed to assess the contribution of obesity and personal history of MDD to clinical outcomes and inflammatory status in study participants. Hs-CRP levels as well as NRS scores were significantly increased in the obese group. Overall, personal history of depression accounted for increased NRS scores but no significant association was found with inflammatory status. In addition, history of depression did not significantly modulate the relationship of obesity-related inflammation with NRS scores. Interestingly, obese individuals with history of recurrent MDD (n = 13) exhibited higher scores in the cognitive and sickness symptoms dimensions of the NRS compared to obese subjects with history of one depressive episode only. Findings indicate that history of depression contributes to neuropsychiatric symptoms, but not to systemic inflammation, in obese subjects free of current depressive episode. These results provide relevant information on the risk factors that may help identify obese subjects with increased risk of neuropsychiatric comorbidity.

摘要

肥胖是与神经精神合并症相关的主要公共卫生负担,导致社会和职业功能受损。鉴于肥胖和精神障碍在全球的患病率不断增加,了解肥胖相关神经精神合并症的危险因素对于制定预防策略和个体化治疗至关重要。最近的研究结果表明,肥胖引起的炎症与肥胖相关的神经精神合并症有关。然而,并非所有患有慢性炎症的肥胖患者都会出现神经精神症状,这表明存在其他危险因素。本研究旨在探讨既往重度抑郁症(MDD)病史对肥胖相关炎症和神经精神症状的影响及其相关性。本研究采用病例对照研究,比较了 66 名肥胖患者(BMI>35kg/m2)和 22 名健康非肥胖参与者,他们均无当前的神经精神疾病,包括 MDD。使用神经毒性评定量表(NRS)评估神经精神症状。收集社会人口统计学和临床变量,并采集血液测量血清高敏 C 反应蛋白(hs-CRP)水平。进行多元回归分析,以评估肥胖和既往 MDD 病史对研究参与者临床结局和炎症状态的影响。肥胖组的 hs-CRP 水平和 NRS 评分显著升高。总的来说,抑郁病史与 NRS 评分增加有关,但与炎症状态无显著相关性。此外,抑郁病史并未显著调节肥胖相关炎症与 NRS 评分之间的关系。有趣的是,既往有反复发作性 MDD 病史的肥胖患者(n=13)在 NRS 的认知和疾病症状维度上的评分高于仅存在一次抑郁发作的肥胖患者。研究结果表明,在无当前抑郁发作的肥胖患者中,抑郁病史与神经精神症状有关,但与系统性炎症无关。这些结果提供了与危险因素相关的信息,可能有助于识别具有更高神经精神合并症风险的肥胖患者。

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