老年女性低性激素浓度与抑郁的相关性：一项观察性研究。

Associations between low sex hormone concentrations and depression in older women: An observational study.

机构信息

Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.

The Institute for Mental and Physical Health and Clinical Translation Strategy Research Centre, Deakin University School of Medicine, Geelong, Australia; Department of Psychiatry, University of Melbourne, Parkville, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.

出版信息

Maturitas. 2023 Oct;176:107822. doi: 10.1016/j.maturitas.2023.107822. Epub 2023 Aug 4.

DOI:10.1016/j.maturitas.2023.107822

PMID:37591034

Abstract

OBJECTIVE

We investigated whether low sex hormone concentrations are associated with depression in older women.

STUDY DESIGN

This was a cross-sectional study of Australian women, aged at least 70 years, not taking medications modulating sex hormone levels. Associations between hormones, measured by liquid chromatography-tandem mass spectrometry, and depression were examined by logistic regression adjusted for potential confounders.

MAIN OUTCOME MEASURES

The primary outcome was a Center for Epidemiologic Studies Depression score >10, designated as 'depression', with an expanded definition that included anti-depressant use as a secondary outcome.

RESULTS

For the 5535 participants in the analysis, median age 74.0 years (interquartile range 71.7-77.7), depression prevalence was 5.8 % (95 % CI 5.2-6.4 %). In the adjusted models, a statistically significantly greater likelihood of depression was seen for women with testosterone and oestrone blood concentrations in quartile 1 compared with quartiles 2-4 (odds ratio 1.33, 95 % CI 1.04 to 1.70, p = 0.022; and 1.37, 95 % CI 1.06 to 1.78, p = 0.017, respectively). For the expanded definition, the odds ratios for the lowest testosterone and oestrone quartile compared with other quartiles were 1.47 (95 % CI 1.24 to 1.75, p < 0.001) and 1.31 (95 % CI 1.09 to 1.58, p < 0.001), respectively. A significant association for low DHEA was seen only for the expanded definition of depression (1.36, 95 % CI 1.13 to 1.64, p = 0.001). Receiver operating characteristic curves showed that the contribution of each sex hormone to the likelihood of depression was small.

CONCLUSIONS

Amongst older women not taking medications that influence sex hormone concentrations, low testosterone and oestrone levels are associated with a greater likelihood of depression, but the effects are small.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number Register (ISRCTN83772183) and clinicaltrials.gov (NCT01038583).

摘要

目的

我们研究了老年女性低性激素浓度是否与抑郁有关。

研究设计

这是一项对澳大利亚女性的横断面研究，年龄至少 70 岁，未服用调节性激素水平的药物。通过逻辑回归调整潜在混杂因素，检查由液相色谱-串联质谱法测量的激素与抑郁之间的关联。

主要观察指标

主要结局为流行病学研究中心抑郁评分>10，定义为“抑郁”，扩大定义包括抗抑郁药使用作为次要结局。

结果

在分析的 5535 名参与者中，中位年龄 74.0 岁（四分位间距 71.7-77.7），抑郁患病率为 5.8%（95%CI 5.2-6.4%）。在调整模型中，与第 2-4 四分位组相比，第 1 四分位组的女性睾酮和雌酮血液浓度具有统计学上更高的抑郁可能性（比值比 1.33，95%CI 1.04-1.70，p=0.022；和 1.37，95%CI 1.06-1.78，p=0.017）。对于扩大的定义，与其他四分位数相比，最低睾酮和雌酮四分位数的比值比为 1.47（95%CI 1.24-1.75，p<0.001）和 1.31（95%CI 1.09-1.58，p<0.001）。仅对于扩大的抑郁定义，低 DHEA 与抑郁的发生有显著相关性（1.36，95%CI 1.13-1.64，p=0.001）。