Department of Internal Medicine, Endocrine Section, Amsterdam UMC, De Boelelaan 1117, Amsterdam 1081 HV, Netherlands.
Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam 1081 HV, Netherlands.
J Affect Disord. 2022 Jan 1;296:103-110. doi: 10.1016/j.jad.2021.09.069. Epub 2021 Sep 25.
Ghrelin, leptin and high-molecular-weight (HMW) adiponectin have been linked to depression in middle-aged adults. Pathophysiological mechanisms of depression change as age progresses and it is unclear whether the same associations exist in older adults.
We analyzed the associations between ghrelin, leptin and HMW adiponectin and depressive symptoms (Center for Epidemiologic Studies Depression (CES-D) score ≥ 16) in a community-dwelling cohort of 898 participants in a multivariable logistic regression analysis at baseline and after three years of follow-up, were applicable stratified by sex, age and waist-hip-ratio (WHR).
At baseline no significant associations were found. After three years of follow-up ghrelin was associated with higher odds for depressive symptoms (fully adjusted continuous analysis OR 2.27, 95% CI 1.42 - 3.61). There was effect modification for age and WHR, with significant associations in participants younger than 69.7 years (median) and with a WHR below 0.9554 (mean). In the sex-stratified analysis for leptin we found significant associations in men (fully adjusted continuous analysis OR 1.07, 95% CI 1.02 - 1.12). For HMW adiponectin there were no significant associations in the multivariable analysis.
As our cohort consisted of relatively healthy participants with intact cognitive function, selection bias may have contributed to lack of significant baseline associations.
Our results show significant associations between ghrelin and - for men only - leptin and depressive symptoms after three years of follow up. This may provide a new therapeutic window for treatment of depressive symptoms in older adults, as both ghrelin and leptin are positively influenced by weight loss.
生长激素释放肽、瘦素和高分子量(HMW)脂联素与中年成年人的抑郁症有关。随着年龄的增长,抑郁症的病理生理机制发生变化,目前尚不清楚这些关联是否存在于老年人中。
我们在一项多变量逻辑回归分析中,分析了社区居住队列中 898 名参与者的生长激素释放肽、瘦素和 HMW 脂联素与抑郁症状(中心流行病学研究抑郁量表(CES-D)评分≥16)之间的关联,该队列在基线和 3 年随访时有性别、年龄和腰围-臀围比(WHR)分层。
在基线时未发现显著关联。在 3 年的随访后,生长激素释放肽与抑郁症状的几率较高相关(完全调整后的连续分析 OR 2.27,95%CI 1.42-3.61)。年龄和 WHR 存在效应修饰,在年龄小于 69.7 岁(中位数)和 WHR 低于 0.9554(平均值)的参与者中存在显著关联。在男性的瘦素性别分层分析中,我们发现存在显著关联(完全调整后的连续分析 OR 1.07,95%CI 1.02-1.12)。在多变量分析中,HMW 脂联素没有显著关联。
由于我们的队列由认知功能完整的相对健康参与者组成,选择偏倚可能导致基线关联不显著。
我们的研究结果表明,在 3 年的随访后,生长激素释放肽与抑郁症状之间存在显著关联 - 仅在男性中 - 瘦素也是如此。这可能为治疗老年人的抑郁症状提供了一个新的治疗窗口,因为生长激素释放肽和瘦素都受到体重减轻的积极影响。