即使在没有亚临床代谢综合征的情况下，年轻成年人的首发轻度抑郁症也是一种动脉粥样硬化前期状态：卵磷脂胆固醇酰基转移酶降低是关键因素。

First-episode mild depression in young adults is a pre-proatherogenic condition even in the absence of subclinical metabolic syndrome: lowered lecithin-cholesterol acyltransferase as a key factor.

作者信息

Maes Michael, Vasupanrajit Asara, Jirakran Ketsupar, Zhou Bo, Tunvirachaisakul Chavit, Almulla Abbas F

机构信息

Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.

Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China.

出版信息

Neuro Endocrinol Lett. 2024 Dec 22;45(7-8):475-491.

PMID:39737498

Abstract

BACKGROUND

Major depression is classified into distinct subtypes: simple (SDMD) and major dysmood disorder (MDMD). MDMD patients exhibit elevated atherogenicity and decreased reverse cholesterol transport (RCT). However, comprehensive data regarding lipid metabolism is absent in first episode (FE)-SDMD.

AIMS

In this case-control study, plasma lipid levels, lecithin-cholesterol acyltransferase (LCAT), free cholesterol, apolipoprotein (Apo)A1, ApoB, and ApoE are compared between academic students with first episode SDMD (FE-SDMD) (n = 44) or SDMD (n = 64) and control students (n = 44), after excluding those with metabolic syndrome (MetS).

RESULTS

LCAT is decreased, and free cholesterol and ApoE increased in subjects with SDMD and FE-SDMD as compared with controls. There were no significant alterations in high-density lipoprotein cholesterol (HDLc), ApoA1, RCT, ApoB and triglycerides in SDMD. LCAT, free cholesterol and atherogenicity indices are significantly associated with suicidal behaviors and the SDMD phenome. The effects of LCAT on those phenome features is completely mediated by free cholesterol and brooding. SDMD and FE-SDMD patients without signs of subclinical MetS show lowered LCAT and increased free cholesterol as compared with normal controls. There are significant interactions between the SDMD and FE-SDMD diagnosis and subclinical MetS, which result in decreased HDLc and RCT, and an increased ApoB/ApoA ratio.

DISCUSSION

FE-SDMD and SDMD are pre-proatherogenic states, because of decreased LCAT, and increased free cholesterol and ApoE, and their intersections with subclinical MetS. These aberrations may drive atherogenicity, and activation of peripheral and central oxidative, neuro-immune, and degenerative pathways. Individuals with FE-SDMD should be screened and treated for increased atherogenicity risk by measuring free cholesterol and ApoE.

摘要

背景

重度抑郁症可分为不同亚型：单纯型（SDMD）和重度心境恶劣障碍（MDMD）。MDMD患者表现出动脉粥样硬化性增加和逆向胆固醇转运（RCT）减少。然而，关于首发（FE）-SDMD患者脂质代谢的全面数据尚缺乏。

目的

在这项病例对照研究中，比较了排除代谢综合征（MetS）患者后，首发SDMD（FE-SDMD）学生（n = 44）或SDMD学生（n = 64）与对照学生（n = 44）的血浆脂质水平、卵磷脂胆固醇酰基转移酶（LCAT）、游离胆固醇、载脂蛋白（Apo）A1、ApoB和ApoE。

结果

与对照组相比，SDMD和FE-SDMD患者的LCAT降低，游离胆固醇和ApoE升高。SDMD患者的高密度脂蛋白胆固醇（HDLc）、ApoA1、RCT、ApoB和甘油三酯无显著变化。LCAT、游离胆固醇和动脉粥样硬化指数与自杀行为和SDMD表型显著相关。LCAT对这些表型特征的影响完全由游离胆固醇和沉思介导。与正常对照组相比，无亚临床MetS体征的SDMD和FE-SDMD患者LCAT降低，游离胆固醇升高。SDMD和FE-SDMD诊断与亚临床MetS之间存在显著相互作用，导致HDLc和RCT降低，ApoB/ApoA比值升高。