Department of Hemodialysis Center, Second Affiliated Hospital of Nantong University (First People's Hospital), Nantong, China.
International Guests Ward, Second Affiliated Hospital of Nantong University (First People's Hospital), Nantong, China.
PeerJ. 2023 Sep 21;11:e16068. doi: 10.7717/peerj.16068. eCollection 2023.
The aim of this study is to examine the factors that contribute to anxiety and depression in individuals undergoing maintenance hemodialysis (MHD), as well as their association with serum levels of brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), and serotonin (5-HT).
In May 2020 and June 2022, 120 MHD patients who received MDH treatment at our hospital were enrolled. The control group was composed of 60 healthy adults (>18) who completed the physical examination at the same time. The serum levels of BDNF, NT-3, and 5-HT in patients and clinical data of MHD patients with different degrees of anxiety and depression were compared. The Pearson correlation was used to evaluate the correlation between anxiety and depression scores and serum BDNF, NT-3,5-HT levels in patients with MHD. Multivariate analysis was employed to analyze the risk factors of anxiety and depression in MHD patients.
The incidence of anxiety and depression in 120 MHD patients was 34.17% (41/120) and 64.17% (77/120), respectively. The levels of serum NT-3 and 5-HT in the anxiety group were higher than those in the non-anxiety and control group, and the levels of serum NT-3 in the non-anxiety group were higher than those in the control group ( < 0.05). The levels of serum BDNF, NT-3 and 5-HT in the depressed group were higher than those in the non-depressed group and control group, and the levels of serum NT-3 in the non-depressed group were higher than those in the control group ( < 0.05). SAS score was positively correlated with serum NT-3 and 5-HT levels, while the SDS score was negatively correlated with serum BDNF and positively correlated with serum NT-3 and 5-HT levels. Female, rural household registration, and restless leg syndrome were independent risk variables for anxiety in patients with MHD ( < 0.05). Rural household registration, economic deterioration, fatigue, insomnia, and vascular pain were independent variables of depression risk in patients with MHD.
Anxiety and depression in patients with MHD are closely related to the levels of serum BDNF, NT-3, and 5-HT. Female, rural household registration, more than eight dialysis times/month, insomnia, and restless leg syndrome are the risk factors for anxiety in patients with MHD. Rural household registration, economic deterioration, fatigue, insomnia, and vascular pain are the risk factors for depression in patients with MHD. The clinical implication of these findings suggests that these indexes may perhaps serve as biological indicators of anxiety and depression amongst patients undergoing MHD. Such investigation can hence contribute to early detection, monitoring, and potentially enable the depiction of novel therapeutic strategies for managing these adverse states.
本研究旨在探讨接受维持性血液透析（MHD）患者焦虑和抑郁的相关因素，以及这些因素与脑源性神经营养因子（BDNF）、神经营养因子-3（NT-3）和 5-羟色胺（5-HT）血清水平的关系。
2020 年 5 月至 2022 年 6 月，我院收治的 120 例 MHD 患者纳入本研究。对照组由同时完成体检的 60 名健康成年人（>18 岁）组成。比较患者和不同程度焦虑和抑郁的 MHD 患者的 BDNF、NT-3 和 5-HT 血清水平及临床资料。采用 Pearson 相关分析评估 MHD 患者焦虑和抑郁评分与血清 BDNF、NT-3、5-HT 水平的相关性。采用多因素分析分析 MHD 患者焦虑和抑郁的危险因素。
120 例 MHD 患者焦虑发生率为 34.17%（41/120），抑郁发生率为 64.17%（77/120）。焦虑组血清 NT-3 和 5-HT 水平高于非焦虑组和对照组，非焦虑组血清 NT-3 水平高于对照组（<0.05）。抑郁组血清 BDNF、NT-3 和 5-HT 水平高于非抑郁组和对照组，非抑郁组血清 NT-3 水平高于对照组（<0.05）。SAS 评分与血清 NT-3 和 5-HT 水平呈正相关，SDS 评分与血清 BDNF 呈负相关，与血清 NT-3 和 5-HT 呈正相关。女性、农村户籍、不安腿综合征是 MHD 患者焦虑的独立危险因素（<0.05）。农村户籍、经济恶化、乏力、失眠、血管性疼痛是 MHD 患者抑郁的独立危险因素。
MHD 患者的焦虑和抑郁与血清 BDNF、NT-3 和 5-HT 水平密切相关。女性、农村户籍、每月透析次数>8 次、失眠、不安腿综合征是 MHD 患者焦虑的危险因素。农村户籍、经济恶化、乏力、失眠、血管性疼痛是 MHD 患者抑郁的危险因素。这些发现的临床意义表明，这些指标可能是 MHD 患者焦虑和抑郁的生物学指标。这种研究可以帮助早期发现、监测，并可能为管理这些不良状态提供新的治疗策略。
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