循环 GDF-15 水平改变可预测男性重性抑郁障碍中激素失衡。
Altered circulating GDF-15 level predicts sex hormone imbalance in males with major depressive disorder.
机构信息
Eye Central, Renmin Hospital of Wuhan University, Wuhan, China.
Nursing Department, Wuhan No.1 Hospital, Wuhan, China.
出版信息
BMC Psychiatry. 2023 Jan 12;23(1):28. doi: 10.1186/s12888-023-04527-z.
BACKGROUND
It has been hypothesized that higher growth differentiation factor 15 (GDF15) level and lower testosterone/ estradiol (T/E) ratio are associated with major depressive disorder (MDD), yet the underlying effect of serum GDF15 on hinting the T/E ratio imbalance is not fully understood. We observed the correlation between serum T/E ratio and circulating GDF15 in male depressed cohort.
METHODS
The sample consisted of participants (aged 18 ~ 65 years) from the Renmin Hospital of Wuhan University with MDD (n = 412) defined according to a Structured Clinical Interview for DSM-V (SCID), and male healthy controls (n = 137). Serum levels of testosterone, estradiol, and depression risk biomarkers (thyroid hormone, lipids, hs-CRP, Tenascin-C [TNC], GDF15, KLF4, Gas6, and sgp130) were measured. The associations among log-transformed T/E ratio and these biomarkers were analyzed using univariate correlation analysis, category analyses, and linear regression adjusting for standard risk factors.
RESULTS
Of the sample, 36.89% had lower T/E ratio (< 10:1) and 10.20% had higher T/E ratio (> 20:1). After multivariable adjustment, T/E ratio was negatively associated with GDF15 (-0.095 [95% CI -0.170 ~ -0.023] standard deviation [SD] change per SD increase in lg[T/E], P = 0.015) and inversely related to TNC (-0.085 [95% CI -0.167 ~ 0.003] standard deviation [SD] change per SD increase in lg[T/E], P = 0.048). Serum T/E ratio was negatively associated with GDF15 level in both FT3, TSH and HDL strata, whereas this association was not observed in TNC. In T/E ratio strata analyses, there is a significant and negative correlation among T/E ratio and GDF15 in depressive patients with sex hormone imbalance, yet this relationship was not investigated in patients with sex hormone balance.
CONCLUSION
In our community-based observation, circulating GDF-15 level was greatly and inversely associated with serum T/E ratio, indicating that higher GDF-15 alerts sex hormone imbalance in patients with MDD.
背景
有假说认为，生长分化因子 15（GDF15）水平升高和睾酮/雌二醇（T/E）比值降低与重度抑郁症（MDD）有关，但血清 GDF15 对提示 T/E 比值失衡的潜在影响尚未完全阐明。我们观察了男性抑郁队列中血清 T/E 比值与循环 GDF15 之间的相关性。
方法
本研究纳入了来自武汉大学人民医院的参与者（年龄 18~65 岁），其中包括根据 DSM-V 定式临床访谈（SCID）诊断为 MDD 的男性患者（n=412）和男性健康对照者（n=137）。检测了血清睾酮、雌二醇和抑郁风险生物标志物（甲状腺激素、血脂、高敏 C 反应蛋白、Tenascin-C[TNC]、GDF15、KLF4、Gas6 和 sgp130）的水平。采用单变量相关分析、分类分析和线性回归分析（校正标准风险因素），分析 T/E 比值与这些生物标志物之间的关系。
结果
在该样本中，36.89%的人 T/E 比值较低（<10:1），10.20%的人 T/E 比值较高（>20:1）。经多变量校正后，T/E 比值与 GDF15 呈负相关（lg[T/E]每增加一个标准差，GDF15 减少 0.095[95%置信区间（CI）-0.170-0.023]，P=0.015），与 TNC 呈负相关（lg[T/E]每增加一个标准差，TNC 减少 0.085[95%CI-0.1670.003]，P=0.048）。在 FT3、TSH 和 HDL 分层中，血清 T/E 比值与 GDF15 水平呈负相关，而在 TNC 中未观察到这种相关性。在 T/E 比值分层分析中，在存在性激素失衡的抑郁患者中，T/E 比值与 GDF15 之间存在显著的负相关，而在性激素平衡的患者中未发现这种关系。
结论
在我们的基于社区的观察中，循环 GDF-15 水平与血清 T/E 比值呈显著负相关，表明较高的 GDF15 提示 MDD 患者存在性激素失衡。
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