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单相和双相抑郁患者以及有快感缺失或自杀意念的抑郁患者的血脂谱/甲状腺功能标志物比较。

Comparison of blood lipid profile/thyroid function markers between unipolar and bipolar depressed patients and in depressed patients with anhedonia or suicidal thoughts.

机构信息

Department of Psychiatry, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China.

Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.

出版信息

Mol Med. 2019 Nov 20;25(1):51. doi: 10.1186/s10020-019-0119-9.

Abstract

BACKGROUND

This study aimed to investigate the differences in the serum levels of glucose, lipid, and thyroid function markers between unipolar and bipolar depressed patients, as well as the effect of anhedonia and suicidal thoughts on the levels of these biochemical parameters.

METHODS

A total of 287 unmedicated depressed patients from January 2016 to December 2017 were included in this study, including 92 bipolar depressions and 195 unipolar depressions. Anhedonia was determined using the item 32 of Symptom Checklist (SCL-90). Suicide ideation was assessed by item 15 of SCL-90.

RESULTS

The bipolar group had significantly lower lipid levels (including triglycerides, cholesterol, low-density lipoprotein cholesterol [LDL], very low-density lipoprotein cholesterol [VLDL]) and insulin resistance index but higher levels of prolactin, low triiodothyronine (T3) and free T3 (FT3) as well as higher incidence of anhedonia as compared with the unipolar group. Depressed patients with anhedonia had significantly higher LDL level than those without anhedonia. Depressed patients with suicidal thoughts had cholesterol and high-density lipoprotein cholesterol (HDL) level. The above-mentioned differences were confirmed by logistic regression analysis. Receiver operating characteristic curve (ROC) analysis showed that the area under the ROC curve (AUC) ranged from 0.546 to 0.685.

CONCLUSION

Triglycerides, cholesterol, LDL, VLDL T3, FT3 levels were significantly different between unipolar and bipolar depressed patients, which might have the potential to be the markers for differential diagnosis. Patients with anhedonia had lower LDL level, while patients with suicidal thoughts had higher levels of cholesterol and HDL as compared with the corresponding control groups.

摘要

背景

本研究旨在探讨单相和双相抑郁患者血清葡萄糖、脂质和甲状腺功能标志物水平的差异,以及快感缺失和自杀意念对这些生化参数水平的影响。

方法

本研究共纳入 2016 年 1 月至 2017 年 12 月期间未经药物治疗的抑郁患者 287 例,其中包括 92 例双相抑郁和 195 例单相抑郁。采用症状清单(SCL-90)第 32 项评估快感缺失,采用 SCL-90 第 15 项评估自杀意念。

结果

与单相抑郁组相比,双相抑郁组的血脂水平(包括甘油三酯、胆固醇、低密度脂蛋白胆固醇 [LDL]、极低密度脂蛋白胆固醇 [VLDL])和胰岛素抵抗指数显著降低,催乳素水平显著升高,三碘甲状腺原氨酸(T3)和游离 T3(FT3)水平降低,快感缺失发生率较高。与无快感缺失的抑郁患者相比,有快感缺失的抑郁患者 LDL 水平显著升高。有自杀意念的抑郁患者胆固醇和高密度脂蛋白胆固醇(HDL)水平较高。上述差异通过逻辑回归分析得到了证实。受试者工作特征曲线(ROC)分析显示,ROC 曲线下面积(AUC)范围为 0.546 至 0.685。

结论

单相和双相抑郁患者的甘油三酯、胆固醇、LDL、VLDL T3、FT3 水平存在显著差异,这些差异可能具有鉴别诊断的潜力。有快感缺失的患者 LDL 水平较低,而有自杀意念的患者胆固醇和 HDL 水平较高。

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