Eye Central, Renmin Hospital of Wuhan University, Wuhan, China.
Nursing Department, Wuhan No.1 Hospital, Wuhan, China.
BMC Psychiatry. 2023 Jan 12;23(1):28. doi: 10.1186/s12888-023-04527-z.
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.
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.
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.
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.
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。
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。
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。
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。
