School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
J Psychosom Res. 2021 Apr;143:110389. doi: 10.1016/j.jpsychores.2021.110389. Epub 2021 Feb 15.
We compared the level of allostatic load (AL) between patients with major depressive disorder (MDD) and non-depressed controls using two definitions of AL: continuous AL scores (AL index) and clinically significant high AL (≥4). We examined whether MDD was associated with AL independent of basic socioeconomic (age, sex, cohabiting status and level of education) and lifestyle factors (smoking and alcohol use).
The MDD patient sample consisted of 177 psychiatric outpatients (mean age 33.7, SD 10.7 years), who were recruited from the Department of Psychiatry at Kuopio University Hospital, Finland, in 2016-19. The non-depressed controls (n = 228, mean age 49.8, SD 10.1 years) lived in the municipality of Lapinlahti, Finland. Ten biomarkers were used to construct the two AL variables. These indicators were systolic and diastolic blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, glucose, creatinine, waist circumference, body mass index (BMI) and C-reactive protein (CRP).
The mean AL scores did not significantly differ between MDD patients (2.97) and non-depressed controls (3.12), thus it was not associated with MDD in univariate analysis. In multivariate models a higher AL index was associated with a 1.42 to 1.82 times higher likelihood of belonging to the MDD group. Furthermore, we found that high AL (i.e. AL ≥ 4) was associated with MDD, with the likelihood ranging between 2.27 and 2.96 compared with the non-depressed controls in multivariate models.
Even young adult patients with MDD appear to display clinically significant, high AL compared with non-depressed controls. Thus, it is important to pay attention to the somatic health of depressed patients in addition to their mental health.
我们通过两种定义的压力负荷（AL）来比较患有重度抑郁症（MDD）的患者和无抑郁对照组之间的 AL 水平：连续 AL 评分（AL 指数）和临床显著高 AL（≥4）。我们检查了 MDD 是否与 AL 有关，而与基本社会经济因素（年龄、性别、同居状况和教育水平）和生活方式因素（吸烟和饮酒）无关。
MDD 患者样本包括 177 名精神病门诊患者（平均年龄 33.7，SD 10.7 岁），他们于 2016-19 年从芬兰库奥皮奥大学医院精神病学系招募。无抑郁对照组（n=228，平均年龄 49.8，SD 10.1 岁）居住在芬兰拉皮塔赫蒂市。使用 10 种生物标志物来构建两种 AL 变量。这些指标包括收缩压和舒张压、总胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯、葡萄糖、肌酐、腰围、体重指数（BMI）和 C 反应蛋白（CRP）。
MDD 患者（2.97）和无抑郁对照组（3.12）之间的平均 AL 评分无显著差异，因此在单因素分析中与 MDD 无关。在多变量模型中，AL 指数较高与属于 MDD 组的可能性增加 1.42 至 1.82 倍相关。此外，我们发现高 AL（即 AL≥4）与 MDD 相关，与无抑郁对照组相比，多变量模型中的可能性在 2.27 至 2.96 之间。
即使是年轻的成年 MDD 患者似乎也表现出与无抑郁对照组相比具有临床意义的高 AL。因此，除了关注患者的心理健康外，还应注意抑郁患者的身体健康。
