重度抑郁症青少年血清氧化应激指标、炎症指标与自杀未遂之间的关联
Association between serum oxidative stress indicators, inflammatory indicators and suicide attempts in adolescents with major depressive disorder.
作者信息
Peng Cao, Xu Mengting, Ye Meng, Yang Weiwei, Fang Maosheng
机构信息
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, China.
Department of Psychiatry, Fourth People's Hospital of Nantong City, Nantong, China.
出版信息
Front Psychiatry. 2025 Feb 24;16:1539158. doi: 10.3389/fpsyt.2025.1539158. eCollection 2025.
BACKGROUND
Progress in research on the neurobiology of suicide behavior in adolescents has notably lagged compared to that of adults. This study aimed to investigate the associations between serum indicators, including oxidative stress (OS) and inflammatory indicators, and psychological factors with suicide attempts (SA) in adolescents with major depressive disorder (MDD) while also exploring potential markers.
METHODS
This study involved the psychological assessment of 106 first-time hospitalized adolescents aged 12 to 18 with MDD and the measurement of serum indicators. Participants were categorized into two groups according to their history of SA within the preceding six months. Screening the best markers for suicide by machine learning algorithms. Multivariable logistic regression was used to assess the correlation between these indicators and suicide. Secondly, Mendelian randomization (MR) was used to initially explore the causal relationship between these serum indicators and suicide.
RESULTS
In adolescents diagnosed with MDD, those who had attempted suicide exhibited elevated serum superoxide dismutase (SOD) activity, reduced nitric oxide (NO) levels, more severe anxiety and depressive symptoms, worse sleep quality, increased exposure to adverse life events, less effective coping strategies, worse parental attachment, more severe alexithymia, and more impulsivity when compared to their counterparts without a history of SA (all p<0.05). The multivariable analyses showed a significant association between serum SOD activity (OR 1.254, 95% CI 1.043-1.534) and anxiety symptoms (OR 1.056, 95% CI 1.020-1.097) with SA in adolescents diagnosed with MDD. The MR analyses showed a causal association between genetically determined low uric acid (UA) levels and a higher risk of SA (OR 0.942 95%CI 0.896-0.991).
CONCLUSION
Serum SOD activity, anxiety symptoms, and UA levels may be potential markers of SA and suicide intent in adolescents with MDD.
背景
与成年人相比，青少年自杀行为的神经生物学研究进展明显滞后。本研究旨在调查包括氧化应激（OS）和炎症指标在内的血清指标以及心理因素与重度抑郁症（MDD）青少年自杀未遂（SA）之间的关联，同时探索潜在标志物。
方法
本研究对106名首次住院的12至18岁MDD青少年进行了心理评估并测量了血清指标。参与者根据其在过去六个月内的SA史分为两组。通过机器学习算法筛选自杀的最佳标志物。使用多变量逻辑回归评估这些指标与自杀之间的相关性。其次，使用孟德尔随机化（MR）初步探索这些血清指标与自杀之间的因果关系。
结果
在诊断为MDD的青少年中，与没有SA史的青少年相比，有自杀未遂史的青少年血清超氧化物歧化酶（SOD）活性升高、一氧化氮（NO）水平降低、焦虑和抑郁症状更严重、睡眠质量更差、遭受不良生活事件的暴露增加、应对策略效果较差、亲子依恋关系更差、述情障碍更严重且冲动性更强（所有p<0.05）。多变量分析显示，血清SOD活性（比值比1.254，95%置信区间1.043 - 1.534）和焦虑症状（比值比1.056，95%置信区间1.020 - 1.097）与诊断为MDD的青少年SA之间存在显著关联。MR分析显示，基因决定的低尿酸（UA）水平与较高的SA风险之间存在因果关联（比值比0.942，95%置信区间0.896 - 0.991）。
结论
血清SOD活性、焦虑症状和UA水平可能是MDD青少年SA和自杀意图的潜在标志物。
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