The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
J Psychiatr Res. 2021 May;137:401-408. doi: 10.1016/j.jpsychires.2021.03.010. Epub 2021 Mar 16.
Psychiatric disorders are severe, debilitating conditions with unknown etiology and are commonly misdiagnosed, when based solely on clinical interviews, because of overlapping symptoms and similar familial patterns. Until now, no valid and objective biomarkers have been used to diagnose and differentiate between psychiatric disorders. We compared clinically tested serum indicators in terms of inflammation (C-reactive protein, complement proteins C3 and C4, and serum Immunoglobulins A, M, and G), nutrients (homocysteine, folate, and vitamin B12), and neurohormones (adrenocorticotropic hormone and cortisol) in patients with schizophrenia (SCZ, n = 1659), bipolar disorder (BD, n = 1901), and major depressive disorder (MDD, n = 1521) to investigate potential biomarkers. A receiver operating characteristic (ROC) curve was used to analyze the diagnostic potential of these analytes. We found that compared with MDD, serum levels of C-reactive protein, C3, C4, and homocysteine were higher in SCZ and BD groups, and folate and vitamin B12 were lower in SCZ and BD groups. In contrast with BD, adrenocorticotropic hormone and cortisol increased in patients with MDD. Although ROC analysis suggested that they were not able to effectively distinguish between the three, these biological indicators showed different patterns in the three disorders. As such, more specific biomarkers should be explored in the future.
精神障碍是一种严重的、使人虚弱的疾病，其病因不明，仅基于临床访谈通常会误诊，因为这些疾病的症状重叠且具有相似的家族模式。到目前为止，还没有有效的客观生物标志物用于诊断和区分精神障碍。我们比较了精神分裂症（SCZ，n=1659）、双相情感障碍（BD，n=1901）和重度抑郁症（MDD，n=1521）患者的临床检测血清指标，包括炎症（C 反应蛋白、补体蛋白 C3 和 C4、血清免疫球蛋白 A、M 和 G）、营养素（同型半胱氨酸、叶酸和维生素 B12）和神经激素（促肾上腺皮质激素和皮质醇），以研究潜在的生物标志物。我们使用受试者工作特征（ROC）曲线来分析这些分析物的诊断潜力。结果发现，与 MDD 相比，SCZ 和 BD 组的血清 C 反应蛋白、C3、C4 和同型半胱氨酸水平较高，而 SCZ 和 BD 组的叶酸和维生素 B12 水平较低。与 BD 相比，MDD 患者的促肾上腺皮质激素和皮质醇增加。尽管 ROC 分析表明它们不能有效地区分这三种疾病，但这些生物标志物在三种疾病中表现出不同的模式。因此，未来应该探索更具特异性的生物标志物。
