van der Feltz-Cornelis Christina M, Bakker Marjan, Kaul Arvind, Kuijpers Taco W, von Känel Roland, van Eck van der Sluijs Jonna F
Department of Health Sciences, Hull York Medical School, University of York, York, UK.
Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands.
Brain Behav Immun Health. 2020 Nov 17;9:100176. doi: 10.1016/j.bbih.2020.100176. eCollection 2020 Dec.
Interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) are biomarkers of systemic low-grade inflammation (SLI) in depression and anxiety. The question if SLI in those conditions is related to comorbid chronic medical conditions has not been resolved. DSM-5 Somatic symptom disorders and related disorders (SSRD) are conditions with serious distress related to physical symptoms as main criterion. They can occur in patients with medically unexplained symptoms (MUS) and in patients with known comorbid chronic medical conditions. Often, comorbid depression and anxiety are present. SSRDs offer the opportunity to explore the role of SLI in relation to mental distress, including trauma, MUS, chronic medical conditions and comorbid mental disorder.
We hypothesized that increased IL-6 and hsCRP may be directly linked to SLI in SSRD, and that comorbid chronic medical conditions, childhood trauma, current stress and comorbid depression and anxiety may be risk factors that account for some of the variance of SLI in SSRD.
We explored these relationships in a large sample of 241 consecutive outpatients with SSRD.
Mean hsCRP level was 3.66 mg/l, and mean IL-6 level was 3.58 pg/ml. IL-6 and hsCRP levels were associated with each other: τ = 0.249, p < .001; a medium size correlation. Comorbid chronic medical conditions, adverse childhood events other than sexual trauma, and current stress levels were not associated with IL-6 or hsCRP levels.
IL-6 and hsCRP are elevated in SSRD, indicating SLI in SSRD independently of comorbid chronic medical conditions. In clinical research, elevated IL-6 and hsCRP can be used as biomarkers of SLI and can indicate risk for childhood sexual abuse in SSRD. Elevated hsCRP may be a biomarker indicating risk for comorbid depression or high pain levels in SSRD as well.
白细胞介素6（IL-6）和高敏C反应蛋白（hsCRP）是抑郁症和焦虑症中全身性低度炎症（SLI）的生物标志物。这些病症中的SLI是否与合并的慢性躯体疾病相关的问题尚未得到解决。《精神疾病诊断与统计手册》第5版中的躯体症状及相关障碍（SSRD）是以与躯体症状相关的严重痛苦为主要标准的病症。它们可发生于有医学上无法解释的症状（MUS）的患者以及已知合并慢性躯体疾病的患者中。通常，会同时存在合并的抑郁症和焦虑症。SSRD为探讨SLI在精神痛苦（包括创伤、MUS、慢性躯体疾病和合并的精神障碍）方面的作用提供了机会。
我们假设IL-6和hsCRP升高可能与SSRD中的SLI直接相关，并且合并的慢性躯体疾病、童年创伤、当前压力以及合并的抑郁症和焦虑症可能是导致SSRD中SLI部分差异的危险因素。
我们在241名连续的SSRD门诊患者的大样本中探讨了这些关系。
hsCRP平均水平为3.66毫克/升，IL-6平均水平为3.58皮克/毫升。IL-6和hsCRP水平相互关联：τ = 0.249，p <.001；为中等程度的相关性。合并的慢性躯体疾病、除性创伤外的童年不良事件以及当前压力水平与IL-6或hsCRP水平无关。
SSRD中IL-6和hsCRP升高，表明SSRD中存在SLI，且独立于合并的慢性躯体疾病。在临床研究中，升高的IL-6和hsCRP可作为SLI的生物标志物，并且可表明SSRD中童年性虐待的风险。升高的hsCRP也可能是表明SSRD中合并抑郁症或高疼痛水平风险的生物标志物。
