血清皮质醇、nesfatin-1 和白细胞介素-1β：治疗抵抗性老年抑郁症患者的潜在诊断生物标志物。
Serum Cortisol, Nesfatin-1, and IL-1β: Potential Diagnostic Biomarkers in Elderly Patients with Treatment-Resistant Depression.
机构信息
Department of Geriatric Psychology, Hefei Fourth People's Hospital, Affiliated Psychological Hospital of Anhui Medical University, Hefei, People's Republic of China.
Department of Medical Education and Research, Anhui Mental Health Center, Hefei, People's Republic of China.
出版信息
Clin Interv Aging. 2022 Apr 21;17:567-576. doi: 10.2147/CIA.S361459. eCollection 2022.
AIM
Treatment-resistant depression (TRD) affects approximately 30% of patients with major depressive disorder (MDD), especially elderly patients. As individuals with TRD are at an increased risk of committing suicide and pose a higher risk of relapse, early diagnostic biomarkers of TRD and a better understanding of the resistance mechanism are highly needed. This study aimed to determine whether serum cortisol, nesfatin-1, and pro-inflammatory cytokines can be used as biomarkers for the diagnosis of elderly patients with TRD.
METHODS
Thirty elderly patients with TRD were selected as the TRD group. Thirty elderly patients with MDD who were effectively treated with conventional antidepressants were selected as the non-TRD group. The baseline levels of serum cortisol, nesfatin-1, and pro-inflammatory cytokines were measured and compared, and their diagnostic values were evaluated using the receiver operating characteristic (ROC) curve method for discriminating patients with TRD from those without TRD.
RESULTS
Serum cortisol, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were significantly higher in the non-TRD and TRD groups than in the control group. Moreover, serum cortisol, CRP, TNF-α, and IL-6 levels in the TRD group were significantly lower than those in the non-TRD group. Furthermore, serum nesfatin-1 levels in the non-TRD group were significantly lower than those in the control and TRD groups, while the serum IL-1β levels in the non-TRD group were significantly higher than those in the control and TRD groups. Additionally, an ROC analysis revealed an area under the curve (AUC) of 0.929 for the combination of nesfatin-1 and IL-1β and an AUC of 0.956 for the combination of cortisol, nesfatin-1, and IL-1β in discriminating elderly patients with TRD from those without non-TRD.
CONCLUSION
Serum cortisol, nesfatin-1, and IL-1β may be potential diagnostic biomarkers for discriminating elderly patients with TRD from those without TRD.
目的
治疗抵抗性抑郁症（TRD）影响约 30%的重性抑郁症（MDD）患者，尤其是老年患者。由于 TRD 患者自杀风险增加且复发风险较高，因此急需确定 TRD 的早期诊断生物标志物并更好地了解其抵抗机制。本研究旨在确定血清皮质醇、nesfatin-1 和促炎细胞因子是否可作为老年 TRD 患者诊断的生物标志物。
方法
选择 30 例老年 TRD 患者作为 TRD 组。选择 30 例经常规抗抑郁药有效治疗的老年 MDD 患者作为非 TRD 组。测量并比较两组患者的血清皮质醇、nesfatin-1 和促炎细胞因子的基线水平，并用受试者工作特征（ROC）曲线法评估其用于区分 TRD 患者与非 TRD 患者的诊断价值。
结果
非 TRD 组和 TRD 组患者的血清皮质醇、C 反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平明显高于对照组，且 TRD 组患者的血清皮质醇、CRP、TNF-α 和 IL-6 水平明显低于非 TRD 组。此外，非 TRD 组患者的血清 nesfatin-1 水平明显低于对照组和 TRD 组，而非 TRD 组患者的血清 IL-1β 水平明显高于对照组和 TRD 组。ROC 分析显示，联合 nesfatin-1 和 IL-1β 区分老年 TRD 患者与非 TRD 患者的曲线下面积（AUC）为 0.929，联合皮质醇、nesfatin-1 和 IL-1β 的 AUC 为 0.956。
结论
血清皮质醇、nesfatin-1 和 IL-1β 可能是区分老年 TRD 患者与非 TRD 患者的潜在诊断生物标志物。
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