Wang Han, Lyu Nan, Huang Juan, Fu Bingbing, Shang Lili, Yang Fan, Zhang Ling, Zhao Qian
Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, Beijing, 100088, China.
Laboratory for Clinical Medicine, Capital Medical University, Beijing, 100069, China.
BMC Psychiatry. 2025 Jul 1;25(1):643. doi: 10.1186/s12888-025-07098-3.
BACKGROUND: Adolescent suicide, as a public health issue, is becoming increasingly urgent, yet there remains a lack of effective objective biomarkers for identifying high-risk adolescents. While testosterone has been linked to suicide, no definitive conclusions have been reached. Studies in specific populations defined by significant changes in age or hormone levels and by gender have shown greater reproducibility. This study aims to investigate the association between testosterone levels and suicidal ideation or behavior in male and female adolescents with major depressive disorder (MDD). METHODS: This retrospective, cross-sectional study included 1227 adolescents with MDD, aged 10-19 years, hospitalized at the Beijing Anding Hospital, Capital Medical University, from January 2013 to December 2020. Patients were categorized into two groups: those with suicidal ideation or behavior (MDS) and those without (MDNS). Demographic data, clinical characteristics, and serum testosterone levels at admission were extracted and compared. An additional 579 adolescents meeting the same inclusion criteria were included for validation, with data collected from January 2022 to December 2023. RESULTS: In male adolescents, testosterone levels were significantly higher in the MDS group compared to the MDNS group(Z = -4.340, P < 0.001). After adjusting for confounding factors, testosterone levels remained significantly associated with suicidal ideation or behavior (OR = 1.220, 95% CI: 1.098-1.356). This finding was confirmed in the validation data set (OR = 1.444, 95% CI: 1.139-1.832). No significant difference in testosterone levels was observed in females (Z = 1.643, P = 0.100). CONCLUSIONS: Elevated serum testosterone levels were independently associated with increased risk of suicidal ideation or behavior in male adolescents with MDD, but not in females. These findings highlight the necessity for sex-specific biomarkers, however, due to the intrinsic limitations of the current study, they necessitate further validation. CLINICAL TRIAL NUMBER: Not applicable.
背景：青少年自杀作为一个公共卫生问题，紧迫性日益凸显，但仍缺乏用于识别高危青少年的有效客观生物标志物。虽然睾酮与自杀有关联，但尚未得出明确结论。在由年龄或激素水平的显著变化以及性别所定义的特定人群中开展的研究显示出更高的可重复性。本研究旨在调查患有重度抑郁症（MDD）的男性和女性青少年的睾酮水平与自杀意念或行为之间的关联。 方法：这项回顾性横断面研究纳入了2013年1月至2020年12月期间在北京安定医院（首都医科大学附属）住院的1227名年龄在10至19岁之间的患有MDD的青少年。患者被分为两组：有自杀意念或行为的患者（MDS）和无自杀意念或行为的患者（MDNS）。提取并比较了人口统计学数据、临床特征以及入院时的血清睾酮水平。另外纳入了579名符合相同纳入标准的青少年进行验证，数据收集时间为2022年1月至2023年12月。 结果：在男性青少年中，MDS组的睾酮水平显著高于MDNS组（Z = -4.340，P < 0.001）。在对混杂因素进行调整后，睾酮水平仍与自杀意念或行为显著相关（OR = 1.220，95% CI：1.098 - 1.356）。这一发现在校正数据集中得到了证实（OR = 1.444，95% CI：1.139 - 1.832）。在女性中未观察到睾酮水平有显著差异（Z = 1.643，P = 0.100）。 结论：血清睾酮水平升高与患有MDD的男性青少年自杀意念或行为风险增加独立相关，但与女性无关。这些发现凸显了性别特异性生物标志物的必要性，然而，由于本研究的内在局限性，它们需要进一步验证。 临床试验编号：不适用。
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