Hu Jieqiong, Ji Yunxin, Lang Xiaoe, Zhang Xiang-Yang
Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China.
Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.
Front Psychiatry. 2023 Feb 14;14:1085105. doi: 10.3389/fpsyt.2023.1085105. eCollection 2023.
Abnormal lipid metabolism in patients with major depressive disorder (MDD) has received increasing attention. The coexistence of MDD and abnormal thyroid function has been intensively studied. Moreover, thyroid function is closely related to lipid metabolism. The aim of this study was to investigate the relationship between thyroid function and abnormal lipid metabolism in young patients with first-episode and drug naïve (FEDN) MDD.
A total of 1,251 outpatients aged 18-44 years with FEDN MDD were enrolled. Demographic data were collected, and lipid and thyroid function levels were measured, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), anti-thyroglobulin antibody (TG-Ab), and anti-thyroid peroxidase antibody (TPO-Ab). The Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale were also assessed for each patient.
Compared with young MDD patients without comorbid lipid metabolism abnormalities, patients with comorbid lipid metabolism abnormalities had higher body mass index (BMI) values, HAMD score, HAMA score, PANSS positive subscale score, TSH levels, TG-Ab levels, and TPO-Ab levels. Binary logistic regression analysis showed that TSH level, HAMD score and BMI were risk factors for abnormal lipid metabolism. TSH levels were an independent risk factor for abnormal lipid metabolism in young MDD patients. Stepwise multiple linear regression showed that both TC and LDL-C levels were positively correlated with TSH levels, HAMD and PANSS positive subscale scores, respectively. HDL-C levels were negatively correlated with TSH levels. TG levels were positively correlated with TSH and TG-Ab levels and HAMD score.
Our results show that thyroid function parameters, especially TSH levels, are implicated in abnormal lipid metabolism in young patients with FEDN MDD.
重度抑郁症（MDD）患者的脂质代谢异常受到越来越多的关注。MDD与甲状腺功能异常的共存已得到深入研究。此外，甲状腺功能与脂质代谢密切相关。本研究的目的是探讨首发未用药的年轻MDD患者（FEDN）甲状腺功能与脂质代谢异常之间的关系。
共纳入1251例年龄在18 - 44岁的FEDN MDD门诊患者。收集人口统计学数据，并测量脂质和甲状腺功能水平，包括总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、抗甲状腺球蛋白抗体（TG-Ab）和抗甲状腺过氧化物酶抗体（TPO-Ab）。还对每位患者进行了汉密尔顿抑郁评定量表（HAMD）、汉密尔顿焦虑评定量表（HAMA）和阳性与阴性症状量表（PANSS）阳性分量表评估。
与无合并脂质代谢异常的年轻MDD患者相比，合并脂质代谢异常的患者体重指数（BMI）值、HAMD评分、HAMA评分、PANSS阳性分量表评分、TSH水平、TG-Ab水平和TPO-Ab水平更高。二元逻辑回归分析显示，TSH水平、HAMD评分和BMI是脂质代谢异常的危险因素。TSH水平是年轻MDD患者脂质代谢异常的独立危险因素。逐步多元线性回归显示，TC和LDL-C水平分别与TSH水平、HAMD和PANSS阳性分量表评分呈正相关。HDL-C水平与TSH水平呈负相关。TG水平与TSH、TG-Ab水平和HAMD评分呈正相关。
我们的结果表明，甲状腺功能参数，尤其是TSH水平，与首发未用药的年轻MDD患者的脂质代谢异常有关。
