患有创伤后应激障碍的平民女性的自杀倾向：与童年虐待、促炎分子及其基因变异的可能联系。
Suicidality in civilian women with PTSD: Possible link to childhood maltreatment, proinflammatory molecules, and their genetic variations.
作者信息
Kawanishi Hitomi, Hori Hiroaki, Yoshida Fuyuko, Itoh Mariko, Lin Mingming, Niwa Madoka, Narita Megumi, Otsuka Takeshi, Ino Keiko, Imai Risa, Fukudo Shin, Kamo Toshiko, Kunugi Hiroshi, Kim Yoshiharu
机构信息
Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
出版信息
Brain Behav Immun Health. 2023 Jun 5;30:100650. doi: 10.1016/j.bbih.2023.100650. eCollection 2023 Jul.
BACKGROUND
Posttraumatic stress disorder (PTSD) is a robust risk factor for suicide. Studies have suggested an association between suicide and elevated inflammatory markers, although such evidence in PTSD is scarce. Suicide risk, PTSD, and inflammatory molecules are all shown to be associated with childhood maltreatment and genetic factors.
METHODS
We examined the association between suicidal ideation/risk and inflammatory markers in 83 civilian women with PTSD, and explored the possible influence of childhood maltreatment and inflammatory genes. Suicidal ideation and risk were assessed using the Beck Depression Inventory-II and the Mini-International Neuropsychiatric Interview. Childhood maltreatment history was assessed with the Childhood Trauma Questionnaire (CTQ). Blood levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and high-sensitivity tumor necrosis factor-α were measured. Genetic polymorphisms of rs2794520 and rs1800796 were genotyped.
RESULTS
Suicidal ideation was significantly positively correlated with hsCRP (p = 0.002) and IL-6 (p = 0.015) levels. Suicide risk weighted score was significantly positively correlated with hsCRP (p = 0.016) levels. The risk alleles of rs2794520 and rs1800796 leading to increased respective protein levels were dose-dependently associated with higher risk of suicide (p = 0.007 and p = 0.029, respectively). The CTQ total score was significantly correlated with suicidal ideation and risk, but not with inflammatory marker levels. Furthermore, a multivariate regression analysis controlling for PTSD severity and potential confounders revealed that rs2794520 and rs1800796, but not hsCRP or IL-6 levels, significantly predicted suicidal ideation (p < 0.001) and risk (p = 0.007), respectively.
CONCLUSION
Genetic variations within inflammatory genes might be useful in detecting PTSD patients at high risk of suicide.
背景
创伤后应激障碍（PTSD）是自杀的一个重要危险因素。研究表明自杀与炎症标志物升高之间存在关联，尽管在PTSD患者中的此类证据较少。自杀风险、PTSD和炎症分子均显示与童年期虐待及遗传因素有关。
方法
我们研究了83名患有PTSD的女性平民中自杀意念/风险与炎症标志物之间的关联，并探讨了童年期虐待和炎症基因的可能影响。使用贝克抑郁量表第二版和迷你国际神经精神访谈评估自杀意念和风险。用儿童创伤问卷（CTQ）评估童年期虐待史。检测高敏C反应蛋白（hsCRP）、白细胞介素-6（IL-6）和高敏肿瘤坏死因子-α的血药浓度。对rs2794520和rs1800796的基因多态性进行基因分型。
结果
自杀意念与hsCRP水平（p = 0.002）和IL-6水平（p = 0.015）显著正相关。自杀风险加权评分与hsCRP水平（p = 0.016）显著正相关。导致各自蛋白水平升高的rs2794520和rs1800796风险等位基因与更高的自杀风险呈剂量依赖性相关（分别为p = 0.007和p = 0.029）。CTQ总分与自杀意念和风险显著相关，但与炎症标志物水平无关。此外，在控制PTSD严重程度和潜在混杂因素的多变量回归分析中，rs2794520和rs1800796分别显著预测了自杀意念（p < 0.001）和风险（p = 0.007），而hsCRP或IL-6水平则不然。
结论
炎症基因内的遗传变异可能有助于检测有高自杀风险的PTSD患者。
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