基线血清脂联素水平较高的患者在接受依西酞普兰治疗后更有可能实现治疗缓解。

Higher baseline serum adiponectin predicts better treatment remission in patients with generalized anxiety disorder treated with escitalopram.

机构信息

School of Medicine, Southeast University, Nanjing, China; Department of Neurosis and Psychosomatic Diseases, Affiliated Huzhou Third Municipal Hospital, Wenzhou Medical University, Huzhou Third Municipal Hospital, Huzhou, China.

Department of Neurology, the Affiliated Dongguan Hospital of Southern Medical University, Dongguan, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7634-7643. doi: 10.21037/apm-21-1542.

DOI:10.21037/apm-21-1542

PMID:34353051

Abstract

BACKGROUND

Generalized anxiety disorder (GAD) is partly attibuted to the dysregulation of nuero-inflammation which can be mediated by adiponectin. We conducted this study was to explore the characteristics of peripheral adiponectin and its role in predicting treatment outcome in patients with generalized anxiety disorder (GAD) treated by escitalopram or venlafaxine.

METHODS

A total of 70 untreated GAD inpatients who met the diagnosis criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) were enrolled and randomly selected for treatment with escitalopram (n=36) or venlafaxine (n=34) for 8 weeks. The serum adiponectin level of GAD and healthy controls (HCs) was measured by enzyme-linked immunosorbent assay (ELISA) before treatment. Hamilton Anxiety Rating Scale (HAM-A) assessment was conducted at baseline and at 1, 2, 4, and 8 weeks after treatment respectively. Serum adiponectin levels were compared between GAD patients and HCs, as well as between remission and nonremission cases; the correlation between baseline adiponectin level and HAM-A reduction rate were also analyzed.

RESULTS

The serum adiponectin levels were higher in GAD patients compared to HCs (t=2.304; P=0.023), the serum adiponectin levels were higher in remission cases compared to nonremission cases (t=2.255, P=0.027), and the receiver operating characteristic (ROC) area in predicting treatment remission was 0.652±0.066 (P=0.029). The correlation between baseline adiponectin level and HAM-A reduction rate of GAD cases treated with escitalopram and venlafaxine in the endpoint was 0.362 (P=0.030) and -0.026 (P=0.883), respectively, and the ROC area of baseline adiponectin level in predicting treatment remission was 0.72±0.086 (P=0.024) and 0.473±0.102 (P=0.469), respectively.

CONCLUSIONS

Peripheral adiponectin is upregulated in GAD, and it seems higher baseline adiponectin level predicts a better treatment remission treated by escitalopram but not with venlafaxine, which suggests adiponectin maybe a potential key biomarker in Chinese GAD.

摘要

背景

广泛性焦虑障碍（GAD）部分归因于神经炎症的失调，而这种失调可以通过脂联素来介导。我们进行这项研究旨在探讨外周脂联素的特征及其在预测接受依西酞普兰或文拉法辛治疗的广泛性焦虑障碍（GAD）患者治疗结果中的作用。

方法

共纳入 70 例未经治疗的符合精神障碍诊断与统计手册第四版（DSM-IV）诊断标准的住院 GAD 患者，并随机选择接受依西酞普兰（n=36）或文拉法辛（n=34）治疗 8 周。采用酶联免疫吸附法（ELISA）测定 GAD 患者和健康对照者（HCs）的血清脂联素水平。分别于基线及治疗后 1、2、4、8 周行汉密尔顿焦虑量表（HAM-A）评估。比较 GAD 患者与 HCs 之间以及缓解与未缓解病例之间的血清脂联素水平；还分析了基线脂联素水平与 HAM-A 降低率之间的相关性。

结果

与 HCs 相比，GAD 患者的血清脂联素水平较高（t=2.304；P=0.023），缓解病例的血清脂联素水平高于未缓解病例（t=2.255，P=0.027），预测治疗缓解的受试者工作特征（ROC）曲线面积为 0.652±0.066（P=0.029）。接受依西酞普兰和文拉法辛治疗的 GAD 患者基线脂联素水平与 HAM-A 降低率在终点时的相关性分别为 0.362（P=0.030）和-0.026（P=0.883），预测治疗缓解的基线脂联素水平的 ROC 曲线面积分别为 0.72±0.086（P=0.024）和 0.473±0.102（P=0.469）。