Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Prog Neuropsychopharmacol Biol Psychiatry. 2019 Jun 8;92:405-411. doi: 10.1016/j.pnpbp.2019.01.010. Epub 2019 Feb 16.
Major depressive disorder (MDD) is a highly prevalent and burdening mental illness. Approximately 30% of the major depressive episodes (MDE) are classified as therapy-refractory. Further knowledge of the pathophysiological mechanisms underlying MDD and predictive biomarkers are needed to improve treatment options.
Serum lipid levels were compared between patients with a current MDE (n = 130) or remitted MDD (n = 39) and healthy control subjects (n = 61) and associated with the severity (17-item Hamilton Depression Rating Scale [HAMD] scores) and the prospective course of depression (direct follow-up of at median 20 days post-inclusion).
We found higher levels of LDL cholesterol (152.5 vs. 134.0 mg/dl, U = 3021, P = 0.008) and LDL/HDL ratio (2.82 vs. 2.21, U = 2912, P = 0.003) in patients with a current MDE than in healthy control subjects. In patients with a current MDE, higher HAMD scores correlated also with higher values of triglycerides (ρ = 0.213, P = 0.015), total cholesterol (ρ = 0.199, P = 0.023), LDL cholesterol (ρ = 0.224, P = 0.010), and LDL/HDL ratio (ρ = 0.196, P = 0.026). Moreover, higher total cholesterol (ρ = -0.233, P = 0.010), LDL cholesterol (ρ = -0.235, P = 0.010), and LDL/HDL ratio (ρ = -0.199, P = 0.029) were associated with a stronger decline in HAMD score between study inclusion and direct follow-up.
We employed an associational study design, performed only a short-term follow-up, and excluded suicidal study subjects.
Serum lipid levels are associated with depression per se, the depression severity, and the prospective 3-week course. These observations build the basis for future investigations on individualized lipid metabolism-related treatment strategies in depressed patients.
重度抑郁症（MDD）是一种高发且负担沉重的精神疾病。大约 30%的重度抑郁发作（MDE）被归类为治疗抵抗。需要进一步了解 MDD 的病理生理机制和预测生物标志物，以改善治疗选择。
比较当前 MDE（n=130）或缓解 MDD（n=39）患者与健康对照（n=61）的血清脂质水平，并与严重程度（17 项汉密尔顿抑郁量表[HAMD]评分）和抑郁的前瞻性病程（直接随访中位数为 20 天）相关。
我们发现，当前 MDE 患者的 LDL 胆固醇水平（152.5 vs. 134.0mg/dl，U=3021，P=0.008）和 LDL/HDL 比值（2.82 vs. 2.21，U=2912，P=0.003）高于健康对照组。在当前 MDE 患者中，较高的 HAMD 评分也与较高的甘油三酯值（ρ=0.213，P=0.015）、总胆固醇（ρ=0.199，P=0.023）、LDL 胆固醇（ρ=0.224，P=0.010）和 LDL/HDL 比值（ρ=0.196，P=0.026）相关。此外，较高的总胆固醇（ρ=-0.233，P=0.010）、LDL 胆固醇（ρ=-0.235，P=0.010）和 LDL/HDL 比值（ρ=-0.199，P=0.029）与 HAMD 评分在研究纳入和直接随访之间的下降幅度更大相关。
我们采用了关联研究设计，仅进行了短期随访，并且排除了有自杀倾向的研究对象。
血清脂质水平与抑郁本身、抑郁严重程度和未来 3 周的病程有关。这些观察结果为未来研究抑郁患者个体化脂质代谢相关治疗策略奠定了基础。
