Wang Wei-Yi, Wu Yi, Zhang Jing-Qi, Li Bin
The Clinical Research Center for Acute Myocardial Infarction of Hubei Province, Xianning Central Hospital, First Affiliated Hospital of Hubei University of Science and Technology, Xianning 437000, Hubei Province, China.
Laboratory of Cardiovascular Internal Medicine Department, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
World J Psychiatry. 2025 Jul 19;15(7):106733. doi: 10.5498/wjp.v15.i7.106733.
Hypertension is a chronic cardiovascular disease characterized by persistently elevated arterial blood pressure. It is not only a significant risk factor for cardiovascular and cerebrovascular diseases (such as myocardial infarction and stroke) but also closely related to multiple organ damages (such as kidney disease and retinopathy), imposing a heavy health and economic burden on individuals and society.
To investigate the expression differences and relationships of endothelin-1 (ET-1), interleukin-6 (IL-6), stem cell factor (SCF), and its receptor (c-kit) in hypertensive patients with or without depression.
A retrospective analysis was conducted on the clinical data of 163 hypertensive patients admitted to our hospital from March 2022 to January 2024. Based on the presence of depression, patients were divided into Group A ( = 77, with depression) and Group B ( = 86, without depression). Serum levels of ET-1 and IL-6 were measured using radioimmunoassay, while serum levels of SCF and c-kit were measured using ELISA. The differences in ET-1, IL-6, SCF, and c-kit levels between Groups A and B were compared. Additionally, the differences in these biomarkers among patients with varying degrees of depression in Group A were analyzed. Pearson correlation analysis was used to examine the relationship between ET-1, IL-6, SCF, c-kit levels, and Hamilton depression rating scale (HAMD) scores. Multivariate logistic regression analysis was performed to identify factors influencing hypertension with depression. The diagnostic efficacy of individual and combined biomarkers was analyzed using receiver operating characteristic (ROC) curves. Comparative statistical analysis of the area under the curve (AUC) values was performed using DeLong's test to assess the superiority of combined biomarker detection.
The levels of ET-1 and IL-6 in Group A were significantly higher than those in Group B, while the levels of SCF and c-kit were significantly lower in Group A compared to Group B ( < 0.05). In the severe depression subgroup, ET-1 and IL-6 levels were higher than those in the mild-to-moderate depression subgroup, while SCF and c-kit levels were lower ( < 0.05). Pearson correlation analysis showed that ET-1 and IL-6 levels were positively correlated with HAMD scores ( = 0.442, 0.463, < 0.05), while SCF and c-kit levels were negatively correlated with HAMD scores ( = -0.429, -0.394, < 0.05). Multivariate logistic regression analysis revealed that high ET-1, high IL-6, low SCF, and low c-kit were independent influencing factors for hypertension with depression ( < 0.05). ROC analysis revealed AUCs of 0.746 (ET-1), 0.801 (IL-6), 0.732 (SCF), 0.779 (c-kit), and 0.884 (combination). The combined diagnosis demonstrated significantly higher AUC than individual markers (DeLong's test, < 0.01), with superior sensitivity (90.24%) and specificity (85.37%).
Compared to patients with hypertension alone, patients with hypertension and depression exhibited higher serum levels of ET-1 and IL-6 and lower levels of SCF and c-kit. High ET-1, high IL-6, low SCF, and low c-kit were independent influencing factors for hypertension with depression. The combination of ET-1, IL-6, SCF, and c-kit demonstrated significant diagnostic value for hypertension with depression.
高血压是一种慢性心血管疾病，其特征为动脉血压持续升高。它不仅是心血管和脑血管疾病（如心肌梗死和中风）的重要危险因素，还与多器官损害（如肾脏疾病和视网膜病变）密切相关，给个人和社会带来沉重的健康和经济负担。
探讨内皮素-1（ET-1）、白细胞介素-6（IL-6）、干细胞因子（SCF）及其受体（c-kit）在伴有或不伴有抑郁症的高血压患者中的表达差异及关系。
对2022年3月至2024年1月我院收治的163例高血压患者的临床资料进行回顾性分析。根据是否存在抑郁症，将患者分为A组（n = 77，伴有抑郁症）和B组（n = 86，不伴有抑郁症）。采用放射免疫法测定血清ET-1和IL-6水平，采用酶联免疫吸附测定法测定血清SCF和c-kit水平。比较A组和B组ET-1、IL-6、SCF和c-kit水平的差异。此外，分析A组中不同抑郁程度患者这些生物标志物的差异。采用Pearson相关分析检验ET-1、IL-6、SCF、c-kit水平与汉密尔顿抑郁量表（HAMD）评分之间的关系。进行多因素逻辑回归分析以确定影响伴有抑郁症的高血压的因素。使用受试者工作特征（ROC）曲线分析单个和联合生物标志物的诊断效能。使用DeLong检验对曲线下面积（AUC）值进行比较统计分析，以评估联合生物标志物检测的优越性。
A组ET-1和IL-6水平显著高于B组，而A组SCF和c-kit水平显著低于B组（P < 0.05）。在重度抑郁亚组中，ET-1和IL-6水平高于轻度至中度抑郁亚组，而SCF和c-kit水平较低（P < 0.05）。Pearson相关分析显示，ET-1和IL-6水平与HAMD评分呈正相关（r = 0.442，0.463，P < 0.05），而SCF和c-kit水平与HAMD评分呈负相关（r = -0.429，-0.394，P < 0.05）。多因素逻辑回归分析显示，高ET-1、高IL-6、低SCF和低c-kit是伴有抑郁症的高血压的独立影响因素（P < 0.05）。ROC分析显示，ET-1的AUC为0.746，IL-6为0.801，SCF为0.732，c-kit为0.779，联合检测为0.
