Chu Ketan, Lin Xi, Li Saisai, Ma Linjuan, Huang Yizhou, Wu Fan, Shou Mengna, Cabarrabang Nazaré Alva Galang, Lan Yibing, Zhou Jianhong
Women's Hospital, School of Medicine, Zhejiang University, 1st Xueshi Rd, Hangzhou, 310006, Zhejiang Province, People's Republic of China.
Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, 310006, Zhejiang Province, China.
BMC Womens Health. 2025 Jan 15;25(1):24. doi: 10.1186/s12905-025-03560-2.
The etiology of depression involves many biological and environmental factors, among which the inflammatory process is an important contributor. However, the role of pro-inflammatory cytokines in postmenopausal depression is unclear. Therefore, we aimed to explore the association between the serum concentrations of four pro-inflammatory cytokines (IL-1β, IL-6, IL-18, and TNF-α) and depressive symptoms in postmenopausal women who had been receiving menopause hormone therapy (MHT) for at least 6 months and postmenopausal women who had not received MHT.
This study included a total of 136 Chinese postmenopausal women aged 40 to 65 years who visited the gynecology outpatient department between June 2020 and December 2022. They were divided into the POST group (n = 94) and the POST + MHT (n = 42) group. Demographic information was collected, and the Hamilton Rating Scale for Depression (HAMD) was used to assess depression. The circulating levels of IL-1β, IL-6, IL-18, and TNF-α were determined using ELISA kits.
According to the HAMD score, 39.36% of the participants in the POST group and 14.29% in the POST + MHT group were considered to have depression. The POST + MHT group had significantly lower serum concentrations of IL-18 and TNF-α than the POST group. Multiple linear regression analysis showed that the serum IL-18 (β = 3.996, 95% CI = 0.508-7.484), and TNF-α levels (β = 4.784, 95% CI = 0.939-8.629) were significant predictors of the HAMD-24 scores in women in the POST group. In addition, age was found to be positively related with the level of depression (β = 0.531, 95% CI = 0.063-0.999).
Postmenopausal women who received MHT had a lower HAMD-24 score as well as lower serum TNF-α and IL-18 levels than women who did not receive MHT. Further, the TNF-α and IL-18 level were positively associated with the HAMD-24 score in women who had not received MHT.
抑郁症的病因涉及多种生物和环境因素，其中炎症过程是一个重要因素。然而，促炎细胞因子在绝经后抑郁症中的作用尚不清楚。因此，我们旨在探讨在接受绝经激素治疗（MHT）至少6个月的绝经后女性和未接受MHT的绝经后女性中，四种促炎细胞因子（IL-1β、IL-6、IL-18和TNF-α）的血清浓度与抑郁症状之间的关联。
本研究共纳入136名年龄在40至65岁之间的中国绝经后女性，她们于2020年6月至2022年12月期间前往妇科门诊就诊。她们被分为POST组（n = 94）和POST + MHT组（n = 42）。收集人口统计学信息，并使用汉密尔顿抑郁量表（HAMD）评估抑郁情况。使用酶联免疫吸附测定试剂盒测定IL-1β、IL-6、IL-18和TNF-α的循环水平。
根据HAMD评分，POST组中39.36%的参与者和POST + MHT组中14.29%的参与者被认为患有抑郁症。POST + MHT组的血清IL-18和TNF-α浓度显著低于POST组。多元线性回归分析显示，血清IL-18（β = 3.996，95%CI = 0.508 - 7.484）和TNF-α水平（β = 4.784，95%CI = 0.939 - 8.629）是POST组女性HAMD-24评分的显著预测因子。此外，发现年龄与抑郁水平呈正相关（β = 0.531，95%CI = 0.063 - 0.999）。
与未接受MHT的女性相比，接受MHT的绝经后女性的HAMD-24评分以及血清TNF-α和IL-18水平更低。此外，在未接受MHT的女性中，TNF-α和IL-18水平与HAMD-24评分呈正相关。
