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大量首次发作、未使用过药物的重度抑郁症患者样本中血脂谱与自杀未遂的关联

Association of Lipid Profile and Suicide Attempts in a Large Sample of First Episode Drug-Naive Patients With Major Depressive Disorder.

作者信息

Ma Yue-Jiao, Zhou Yong-Jie, Wang Dong-Fang, Li Yi, Wang Dong-Mei, Liu Tie-Qiao, Zhang Xiang-Yang

机构信息

Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China.

Department of Addictive Behavior and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.

出版信息

Front Psychiatry. 2020 Sep 30;11:543632. doi: 10.3389/fpsyt.2020.543632. eCollection 2020.

Abstract

Several studies have reported a link between lipid disorders and suicidality. However, few studies have investigated the relationship between suicidal behavior and blood lipid profiles in patients with first-episode and drug-naive (FEDN) major depressive disorder (MDD). The main purpose of this study was to examine the relationship between plasma lipid profiles and suicide attempts in a large sample of FEDN MDD patients in the Chinese Han population, which has not been reported. A total of 1,718 MDD outpatients were recruited. Their clinical and demographic data as well as plasma lipid parameters were collected. We obtained suicide attempt data through interviews with patients and their family members. We rated the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) for all patients. The suicide attempt rate of MDD patients was 20.14%, of which 13.68% in the last month and 6.46% in the past. Further, compared with non-attempters, suicide attempters had significantly higher total levels of cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c), higher HAMA and HAMD scores, but significantly lower high-density lipoprotein cholesterol (HDL-c) levels. Logistic regression analysis showed that suicide attempts were correlated with higher TC, lower HDL-c, and higher HAMA and HAMD scores with the adjusted odds ratio (OR) of 1.35, 0.52,1.28, and 1.08, respectively (all p < 0.05). Our findings suggest that FEDN patients with MDD have a high rate of attempted suicide. In the early stage of MDD patients, certain blood lipid parameters and more severe symptoms of anxiety and depression are correlated with suicide attempts. However, due to the cross-sectional design of this study, it is impossible to draw a causal relationship between lipid profiles and suicide attempts. Moreover, an inverse correlation can also be considered, that is, high cholesterol may be the consequence of suicide attempts and depression.

摘要

多项研究报告了脂质紊乱与自杀倾向之间的联系。然而,很少有研究调查首发且未服用过药物的重性抑郁障碍(MDD)患者的自杀行为与血脂谱之间的关系。本研究的主要目的是在中国汉族人群的大量首发且未服用过药物的重性抑郁障碍患者样本中,检验血浆脂质谱与自杀未遂之间的关系,此前尚未有相关报道。共招募了1718名重性抑郁障碍门诊患者。收集了他们的临床和人口统计学数据以及血浆脂质参数。我们通过与患者及其家属访谈获得自杀未遂数据。对所有患者进行汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分。重性抑郁障碍患者的自杀未遂率为20.14%,其中上个月为13.68%,过去为6.46%。此外,与未自杀未遂者相比,自杀未遂者的总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-c)水平显著更高,HAMA和HAMD评分更高,但高密度脂蛋白胆固醇(HDL-c)水平显著更低。逻辑回归分析显示,自杀未遂与较高的TC、较低的HDL-c以及较高的HAMA和HAMD评分相关,调整后的优势比(OR)分别为1.35、0.52、1.28和1.08(均p<0.05)。我们的研究结果表明,首发且未服用过药物的重性抑郁障碍患者有较高的自杀未遂率。在重性抑郁障碍患者早期,某些血脂参数以及更严重的焦虑和抑郁症状与自杀未遂相关。然而,由于本研究的横断面设计,无法得出血脂谱与自杀未遂之间的因果关系。此外,也可以考虑反向关联,即高胆固醇可能是自杀未遂和抑郁的结果。

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