跑步疗法或抗抑郁药作为抑郁和焦虑症患者免疫代谢性抑郁症的治疗方法：MOTAR研究的二次分析
Running therapy or antidepressants as treatments for immunometabolic depression in patients with depressive and anxiety disorders: A secondary analysis of the MOTAR study.
作者信息
Vreijling Sarah R, Penninx Brenda W J H, Verhoeven Josine E, Teunissen Charlotte E, Blujdea Elena R, Beekman Aartjan T F, Lamers Femke, Jansen Rick
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; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands.
出版信息
Brain Behav Immun. 2025 Jan;123:876-883. doi: 10.1016/j.bbi.2024.10.033. Epub 2024 Oct 28.
BACKGROUND
Exercise promotes immunometabolic health and is increasingly recognized as an effective depression treatment. Exercise may be beneficial for patients with immunometabolic depression (IMD), who experience inflammatory and metabolic dysregulations and may respond less to antidepressants. This secondary analysis of the MOTAR study compared the effects of running therapy and antidepressants on IMD features among patients with depression and/or anxiety disorder. We additionally assessed whether baseline IMD moderated intervention effects on depression.
METHODS
Participants received 16 weeks of group-based running therapy (N = 96) or escitalopram/sertraline (N = 45) in a partially randomized patient preference design. IMD features included atypical, energy-related symptom (AES) severity, inflammation index (CRP, IFN-γ, IL-6, TNF-α), metabolic syndrome index, three metabolite principle components (PC) (derived from 73 metabolites) and a composite IMD index.
RESULTS
Interventions differed in changes in the metabolic syndrome index (d = 0.59, p = 0.026) and IMD index (d = 0.85, p < 0.001). While running therapy decreased both outcomes, the antidepressant group showed an increased IMD index. Although groups did not differ statistically significant in changes in AES severity, inflammation index, and metabolite PC1, results indicated a consistent trend towards greater improvement with running therapy across these outcomes as well (d = 0.38 to 0.52). Baseline IMD did not moderate intervention effects on depression outcomes.
CONCLUSIONS
This study suggests that exercise more effectively targets the IMD dimension than antidepressants. Patients with IMD did not benefit more from running therapy than antidepressants in terms of reductions in depression. Exercise should be considered an alternative or complementary treatment to particularly reduce IMD features in depressed patients.
TRIAL REGISTRATION
Trialregister.nl Number of identification: NTR3460.
背景
运动可促进免疫代谢健康，越来越被视为一种有效的抑郁症治疗方法。运动可能对免疫代谢性抑郁症（IMD）患者有益，这类患者存在炎症和代谢失调，对抗抑郁药的反应可能较差。这项对MOTAR研究的二次分析比较了跑步疗法和抗抑郁药对抑郁症和/或焦虑症患者IMD特征的影响。我们还评估了基线IMD是否会调节干预对抑郁症的影响。
方法
参与者在部分随机的患者偏好设计中接受了16周的团体跑步疗法（N = 96）或艾司西酞普兰/舍曲林（N = 45）治疗。IMD特征包括非典型、与能量相关症状（AES）严重程度、炎症指数（CRP、IFN-γ、IL-6、TNF-α）、代谢综合征指数、三个代谢物主成分（PC）（源自73种代谢物）以及综合IMD指数。
结果
干预在代谢综合征指数变化（d = 0.59，p = 0.026）和IMD指数变化（d = 0.85，p < 0.001）方面存在差异。虽然跑步疗法使这两个结果均降低，但抗抑郁药组的IMD指数有所增加。尽管两组在AES严重程度、炎症指数和代谢物PC1变化方面无统计学显著差异，但结果表明在这些结果上跑步疗法也有更明显改善的一致趋势（d = 0.38至0.52）。基线IMD并未调节干预对抑郁症结果的影响。
结论
这项研究表明，与抗抑郁药相比，运动能更有效地针对IMD维度。在降低抑郁症方面，IMD患者从跑步疗法中获得的益处并不比抗抑郁药更多。应考虑将运动作为一种替代或补充治疗方法，以特别减少抑郁症患者的IMD特征。
试验注册
Trialregister.nl识别号：NTR3460。
Zotero 插件