Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China.
Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.
J Psychiatr Res. 2023 Jul;163:55-62. doi: 10.1016/j.jpsychires.2023.05.016. Epub 2023 May 12.
Studies have shown an association between abnormal lipid profiles and MDD, but there are few studies on the clinical correlates of lipid abnormalities in patients with major depressive disorder (MDD). The purpose of this study was to investigate the prevalence of abnormal lipid metabolism and its correlates in Chinese first-episode and drug-naïve MDD patients, which has not yet been reported.
A total of 1718 outpatients with first-episode and drug-naïve MDD were included. Demographic data were collected by a standardized questionnaire and blood lipid levels were measured, including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression of Severity Scale (CGI-S) were assessed for each patient.
The prevalence of abnormal lipid metabolism was 72.73% (1301/1718), and the rates of high TC, high TG, high LDL-C and low HDL-C were 51.05% (877/1718), 61.18% (1051/1718), 30.09% (517/1718), 23.40% (402/1718), respectively. Logistic regression showed the risk factors for abnormal lipid metabolism were severe anxiety, HAMD score, CGI-S score, BMI and systolic blood pressure (SBP). Multiple linear regression analysis showed that age at onset, SBP, HAMD score, HAMA score, PANSS positive subscale score, and CGI-S were independently associated with TC levels. BMI, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with TG levels. SBP, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with LDL-C levels. Age of onset, SBP and CGI-S score were independently associated with HDL-C levels.
The prevalence of abnormal lipid metabolism in first-episode and drug-naïve MDD patients is quite high. The severity of psychiatric symptoms may be closely associated with the presence of abnormal lipid metabolism in patients with MDD.
研究表明血脂异常与 MDD 之间存在关联，但关于首发未用药的 MDD 患者脂质异常的临床相关性研究较少。本研究旨在调查中国首发未用药 MDD 患者中异常脂质代谢的发生率及其相关因素，这在以前的研究中尚未报道过。
共纳入 1718 例首发未用药的 MDD 患者。通过标准化问卷收集人口统计学数据，并测量血脂水平，包括总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）。对每位患者进行汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、阳性和阴性综合征量表（PANSS）阳性分量表和临床总体印象严重度量表（CGI-S）评估。
异常脂质代谢的患病率为 72.73%（1301/1718），高 TC、高 TG、高 LDL-C 和低 HDL-C 的发生率分别为 51.05%（877/1718）、61.18%（1051/1718）、30.09%（517/1718）、23.40%（402/1718）。Logistic 回归显示，异常脂质代谢的危险因素是严重焦虑、HAMD 评分、CGI-S 评分、BMI 和收缩压（SBP）。多元线性回归分析显示，发病年龄、SBP、HAMD 评分、HAMA 评分、PANSS 阳性分量表评分和 CGI-S 与 TC 水平独立相关。BMI、HAMD 评分、PANSS 阳性分量表评分和 CGI-S 与 TG 水平独立相关。SBP、HAMD 评分、PANSS 阳性分量表评分和 CGI-S 与 LDL-C 水平独立相关。发病年龄、SBP 和 CGI-S 评分与 HDL-C 水平独立相关。
首发未用药 MDD 患者异常脂质代谢的患病率相当高。精神症状的严重程度可能与 MDD 患者脂质代谢异常密切相关。
