免疫代谢抑制特征在光疗对抑郁症合并 2 型糖尿病患者的作用中的作用：一项随机对照试验。

The role of immuno-metabolic depression features in the effects of light therapy in patients with depression and type 2 diabetes mellitus: A randomized controlled trial.

机构信息

Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands.

Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands.

出版信息

J Psychosom Res. 2024 Jun;181:111671. doi: 10.1016/j.jpsychores.2024.111671. Epub 2024 Apr 15.

DOI:10.1016/j.jpsychores.2024.111671

PMID:38657564

Abstract

OBJECTIVE

Immuno-metabolic depression (IMD) is proposed to be a form of depression encompassing atypical, energy-related symptoms (AES), low-grade inflammation and metabolic dysregulations. Light therapy may alleviate AES by modulating inflammatory and metabolic pathways. We investigated whether light therapy improves clinical and biological IMD features and whether effects of light therapy on AES or depressive symptom severity are moderated by baseline IMD features. Associations between changes in symptoms and biomarkers were explored.

METHODS

In secondary analyses, clinical trial data was used from 77 individuals with depression and type 2 diabetes mellitus (T2DM) randomized to four weeks of light therapy or placebo. AES severity and depressive symptom severity were based on the Inventory of Depressive Symptomatology. Biomarkers included 73 metabolites (Nightingale) summarized in three principal components and CRP, IL-6, TNF-α, INF-γ. Linear regression analyses were performed.

RESULTS

Light therapy had no effect on AES severity, inflammatory markers and metabolite principle components versus placebo. None of these baseline features moderated the effects of light therapy on AES severity. Only a principle component reflecting metabolites implicated in glucose homeostasis moderated the effects of light therapy on depressive symptom severity (βinteraction = 0.65, P = 0.001, FDR = 0.003). Changes in AES were not associated with changes in biomarkers.

CONCLUSION

Findings do not support the efficacy of light therapy in reducing IMD features in patients with depression and T2DM. We find limited evidence that light therapy is a more beneficial depression treatment among those with more IMD features. Changes in clinical and biological IMD features did not align over four-weeks' time.

TRIAL REGISTRATION

The Netherlands Trial Register (NTR) NTR4942.

摘要

目的

免疫代谢抑郁（IMD）被认为是一种包含非典型、与能量相关症状（AES）、低度炎症和代谢紊乱的抑郁形式。光疗可能通过调节炎症和代谢途径来缓解 AES。我们研究了光疗是否能改善临床和生物学 IMD 特征，以及光疗对 AES 或抑郁症状严重程度的影响是否受到基线 IMD 特征的调节。还探讨了症状和生物标志物变化之间的相关性。

方法

在二次分析中，我们使用了来自 77 名患有抑郁症和 2 型糖尿病（T2DM）的个体的临床试验数据，这些个体被随机分配接受四周的光疗或安慰剂治疗。AES 严重程度和抑郁症状严重程度基于抑郁症状清单进行评估。生物标志物包括 Nightingale 汇总的 73 种代谢物，分为三个主要成分，以及 CRP、IL-6、TNF-α、INF-γ。进行了线性回归分析。

结果

与安慰剂相比，光疗对 AES 严重程度、炎症标志物和代谢物主成分没有影响。这些基线特征都没有调节光疗对 AES 严重程度的影响。只有一个反映与葡萄糖稳态相关的代谢物的主成分调节了光疗对抑郁症状严重程度的影响（β交互作用=0.65，P=0.001，FDR=0.003）。AES 的变化与生物标志物的变化无关。