Cao Fang, Yang Mei, Cheng Yuqi, Zhang Xiuyue, Shi Li, Li Na
The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
The Third People's Hospital of Yunnan Province, Kunming, Yunnan, China.
Front Aging Neurosci. 2023 May 4;15:1081393. doi: 10.3389/fnagi.2023.1081393. eCollection 2023.
Type 2 diabetes mellitus (T2DM) and major depressive disorder (MDD) are both chronic diseases, and they are often co-morbid. Usually, T2DM and MDD are associated with cognitive impairment, and the comorbidity status of both may increase the risk of cognitive impairment, but the underlying pathogenesis is not clear. Studies have shown that inflammation, especially monocyte chemoattractant protein-1 (MCP-1), could be associated with the pathogenesis of type 2 diabetes mellitus comorbid major depressive disorder.
To investigate the correlations of MCP-1 with clinical characteristics and cognitive impairment in type 2 diabetes mellitus patients combined with major depressive disorder.
A total of 84 participants were recruited in this study, including 24 healthy controls (HC), 21 T2DM patients, 23 MDD patients, and 16 T2DM combined with MDD (TD) patients, to measure the serum MCP-1 levels using Enzyme-linked Immunosorbent Assay (ELISA). And the cognitive function, depression, and anxiety degree were assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), 17-item Hamilton Depression Scale (HAMD-17), and Hamilton Anxiety Scale (HAMA), respectively.
(1) Serum MCP-1 expression levels in the TD group were higher than HC, T2DM, and MDD groups, respectively ( < 0.05). And compared with HC and MDD groups, serum MCP-1 levels in the T2DM group were higher ( < 0.05) statistically. Receiver Operating Characteristic (ROC) curve showed that MCP-1 could diagnose T2DM at cut-off values of 503.8 pg./mL (sensitivity 80.95%, specificity 79.17%, AUC = 0.7956) and of 718.1 pg./mL for TD (sensitivity 81.25%, specificity 91.67%, AUC = 0.9271). (2) Group differences in cognitive function were significant. Compared with the HC group, total RBANS scores, attention scores, and language scores in the TD group were lower, respectively ( < 0.05), and total RBANS scores, attention scores, and visuospatial/constructional scores in the MDD group were lower, respectively ( < 0.05). Compared with the T2DM group, immediate memory scores in HC, MDD, and TD groups were lower, respectively, and total RBANS scores in TD were lower ( < 0.05). (3) Correlation analysis showed that hip circumference was negatively correlated with MCP-1 levels in the T2DM group ( = -0.483, = 0.027), but the correlation disappeared after adjusting age and gender ( = -0.372; = 0.117), and there were no significant correlations between MCP-1 and other variables.
MCP-1 may be involved in the pathophysiology of type 2 diabetes mellitus patients combined with major depressive disorder. And MCP-1 may be significant for the early evaluation and diagnosis of TD in the future.
2型糖尿病（T2DM）和重度抑郁症（MDD）均为慢性疾病，且常合并存在。通常，T2DM和MDD与认知功能障碍相关，二者的合并状态可能会增加认知功能障碍的风险，但其潜在发病机制尚不清楚。研究表明，炎症，尤其是单核细胞趋化蛋白-1（MCP-1），可能与2型糖尿病合并重度抑郁症的发病机制有关。
探讨MCP-1与2型糖尿病合并重度抑郁症患者临床特征及认知功能障碍的相关性。
本研究共纳入84名参与者，包括24名健康对照者（HC）、21名T2DM患者、23名MDD患者和16名T2DM合并MDD（TD）患者，采用酶联免疫吸附测定法（ELISA）检测血清MCP-1水平。并分别使用可重复性神经心理状态评估量表（RBANS）、17项汉密尔顿抑郁量表（HAMD-17）和汉密尔顿焦虑量表（HAMA）评估认知功能、抑郁和焦虑程度。
（1）TD组血清MCP-1表达水平分别高于HC组、T2DM组和MDD组（<0.05）。与HC组和MDD组相比，T2DM组血清MCP-1水平在统计学上更高（<0.05）。受试者工作特征（ROC）曲线显示，MCP-1在截断值为503.8 pg./mL时可诊断T2DM（敏感性80.95%，特异性79.17%，AUC = 0.7956），在截断值为718.1 pg./mL时可诊断TD（敏感性81.25%，特异性91.67%，AUC = 0.9271）。（2）认知功能的组间差异显著。与HC组相比，TD组的RBANS总分、注意力得分和语言得分分别较低（<0.05），MDD组的RBANS总分、注意力得分和视觉空间/构建得分分别较低（<0.05）。与T2DM组相比，HC组、MDD组和TD组的即时记忆得分分别较低，TD组的RBANS总分较低（<0.05）。（3）相关性分析显示，T2DM组中臀围与MCP-1水平呈负相关（= -0.483，= 0.027），但在调整年龄和性别后相关性消失（= -0.372；= 0.117），且MCP-1与其他变量之间无显著相关性。
MCP-1可能参与2型糖尿病合并重度抑郁症患者的病理生理过程。并且MCP-1可能对未来TD的早期评估和诊断具有重要意义。
