Lis Michał, Majdowski Maciej, Miłuch Tymoteusz, Zawodny Tomasz, Wasilewska Olivia, Kwiatkowska Adriana
Department of Internal Medicine, Endocrinology, Diabetology, Czerniakowski Hospital, Warsaw, Poland.
Faculty of Medicine, Lazarski University, Warsaw, Poland.
Endocr Connect. 2025 Aug 27;14(8). doi: 10.1530/EC-25-0263. Print 2025 Aug 1.
Major depressive disorder (MDD) prevalence increases every year, with approximately 30% of patients remaining treatment-resistant. Ghrelin, a stomach-derived appetite-stimulating hormone, has been implicated in mood disorders, stress response, sleep-cycle regulation, reward behaviour, and neuroplasticity. However, findings in humans remain unconclusive, with reports of higher, unchanged, or lowered ghrelin concentration in patients with MDD. Psychotic-like experiences (PLEs), which are more common in the course of depression, might contribute to reported inconsistencies. This study aims to assess serum total ghrelin concentrations in individuals with depressive symptoms and investigate whether the presence of PLEs modulates the relationship. A cross-sectional study was conducted among 56 individuals screened for depressive symptoms (with patient health questionnaire-9 (PHQ-9)) and presence of PLEs in the past year (with prodromal questionnaire-16 (PQ-16)). Serum total ghrelin levels were determined by enzyme-linked immunosorbent assay (ELISA). The relationship between PHQ-9 scores and total ghrelin was analysed using linear regression and analysis of covariates (ANCOVA) when controlled for sex, age, and body mass index. Initially, depressive symptoms predicted lower ghrelin levels (P = 0.044). However, the model lost its significance when adjusted for covariates (P = 0.100). Pairwise comparisons revealed lower total ghrelin among patients with MDD but without PLEs when compared to controls (P = 0.037). No significant differences were observed within patients with a history of PLEs. This study provides preliminary evidence that PLEs modulate ghrelin secretion in patients with MDD symptoms. Further studies with larger samples are needed to clarify ghrelin's role in MDD pathophysiology.
重度抑郁症（MDD）的患病率逐年上升，约30%的患者对治疗无反应。胃饥饿素是一种由胃产生的刺激食欲的激素，与情绪障碍、应激反应、睡眠周期调节、奖赏行为和神经可塑性有关。然而，人类研究结果尚无定论，关于MDD患者胃饥饿素浓度升高、不变或降低的报道均有。精神病性体验（PLEs）在抑郁症病程中更为常见，可能导致了报道结果的不一致。本研究旨在评估有抑郁症状个体的血清总胃饥饿素浓度，并调查PLEs的存在是否会调节这种关系。对56名筛查出有抑郁症状（使用患者健康问卷-9（PHQ-9））且在过去一年中有PLEs（使用前驱问卷-16（PQ-16））的个体进行了横断面研究。通过酶联免疫吸附测定（ELISA）测定血清总胃饥饿素水平。在控制性别、年龄和体重指数后，使用线性回归和协方差分析（ANCOVA）分析PHQ-9评分与总胃饥饿素之间的关系。最初，抑郁症状预示着胃饥饿素水平较低（P = 0.044）。然而，在调整协变量后，该模型失去了显著性（P = 0.100）。两两比较显示，与对照组相比，MDD患者但无PLEs者的总胃饥饿素水平较低（P = 0.037）。有PLEs病史的患者之间未观察到显著差异。本研究提供了初步证据，表明PLEs调节MDD症状患者的胃饥饿素分泌。需要进一步进行更大样本量的研究来阐明胃饥饿素在MDD病理生理学中的作用。
