目的 检测青少年抑郁症首发患者血清25-羟基维生素D3[25-(OH)D3]、维生素D结合蛋白(VDBP)水平,并分析其临床意义。方法 选取2021年4月—2022年3月秦皇岛市第一医院收治的100例青少年抑郁症首发患者为抑郁症组,并选取同期100例体检健康青少年为对照组。酶联免疫吸附法检测血清25-(OH)D3、VDBP水平;汉密尔顿抑郁量表(HAMD)评定抑郁症患者抑郁程度,分为轻度组(n=41)、中度组(n=32)、重度组(n=27);比较抑郁症组和对照组、不同抑郁程度青少年抑郁症首发患者血清25-(OH)D3、VDBP水平;分析青少年抑郁症首发患者血清25-(OH)D3、VDBP水平与HAMD评分的相关性及首发青少年抑郁症发生的影响因素。结果 与对照组相比,抑郁症组患者血清25-(OH)D3水平降低(t=10.625,P<0.05),VDBP水平升高(t=13.158,P<0.05);轻、中、重度首发青少年抑郁症患者血清25-(OH)D3水平依次降低(F=58.319,P<0.05),VDBP水平依次升高(F=18.805,P<0.05);青少年抑郁症首发患者血清25-(OH)D3水平与HAMD评分、VDBP呈负相关(r=-0.517、-0.511,P<0.05),血清VDBP水平与HAMD评分呈正相关(r=0.498,P<0.05);血清25-(OH)D3缺乏(OR=1.775)、VDBP高水平(OR=1.519)是影响首发青少年抑郁症发生的危险因素(P<0.05)。结论 青少年抑郁症首发患者血清25-(OH)D3水平较低,VDBP水平较高,25-(OH)D3与VDBP呈负相关,且均与HAMD评分显著相关,VDBP、25-(OH)D3可作为判定青少年抑郁症患者病情严重程度的辅助指标。
Abstract
Objective To test the levels of serum 25-hydroxyvitamin D3[25-(OH)D3] and vitamin D-binding protein (VDBP) in adolescent patients with first-episode depressive disorder, and to analyze their clinical significance. Method A total of 100 adolescent patients with first-episode depressive disorder admitted to Qinhuangdao First Hospital from April 2021 to March 2022 were selected as the depression group, and 100 healthy adolescents who took physical examinations during the same period were selected as the control group. The levels of serum 25-(OH)D3 and VDBP were detected by enzyme-linked immunosorbent assay. Hamilton Depression Scale (HAMD) was used to assess the degree of depression in patients with depression, and then the adolescents were divided into mild group (n=41), moderate group (n=32) and severe group (n=27). The levels of serum 25-(OH)D3 and VDBP among depression group, control group and adolescent patients with first-episode depressive disorder with different degrees of depression were compared. The correlation of serum 25-(OH)D3 and VDBP levels with HAMD score in adolescent patients with first-episode depressive disorder and the influencing factors of the occurrence of first-episode depressive disorder were analyzed. Results Compared with the control group, the level of serum 25-(OH)D3 in the depression group decreased (t=10.625, P<0.05), while the level of VDBP increased (t=13.158, P<0.05). The level of serum 25-(OH)D3 of children in mild, moderate and severe depression group decreased in turn (t=58.319, P<0.05), while the level of VDBP increased in turn (F=18.805, P<0.05). Serum 25-(OH)D3 level was negatively correlated with HAMD score and VDBP in adolescent patients with first-episode depressive disorder (r=-0.517, -0.511, P<0.05), while serum VDBP level was positively correlated with HAMD score (r=0.498, P<0.05). Serum 25-(OH)D3 deficiency(OR=1.775) and high level of VDBP (OR=1.519) were risk factors for the occurrence of first-episode depressive disorder (P<0.05). Conclusions The serum 25-(OH)D3 level is lower in the adolescent patients with first-episode depressive disorder, and the VDBP level is higher.Serum 25-(OH)D3level is negatively correlated with VDBP, both of which were significantly correlated with HAMD scores. Both VDBP and 25-(OH)D3 can be used as auxiliary indicators to determine the severity of adolescent depression.
关键词
首发青少年抑郁症 /
25-羟基维生素D3 /
维生素D结合蛋白 /
汉密尔顿抑郁量表
Key words
adolescent patients with first-episode depressive disorder /
25-(OH)D3 /
vitamin D-binding protein /
Hamilton Depression Scale
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参考文献
[1] 胡淑文, 钟慧, 莫大明, 等. 青少年抑郁障碍患者心理理论能力与自杀未遂的相关性研究[J]. 中华行为医学与脑科学杂志, 2022, 31(3):241-247.
Hu SW, Zhong H, Mo DM, et al. Correlation between theory of mind and attempted suicide in adolescents with depressive disorder[J]. Chin J Behav Med Brain Sci, 2022, 31(3):241-247.
[2] Zhang CY, Voort JLV, Yuruk D, et al. A characterization of the clinical global impression scale thresholds in the treatment of adolescent depression across multiple rating scales[J]. J Child Adolesc Psychopharmacol, 2022, 32(5):278-287.
[3] Colasanto M, Madigan S, Korczak DJ. Depression and inflammation among children and adolescents: A meta-analysis[J]. J Affect Disord, 2020, 277(12):940-948.
[4] Pitsillou E, Bresnehan SM, Kagarakis EA, et al. The cellular and molecular basis of major depressive disorder: Towards a unified model for understanding clinical depression[J]. Mol Biol Rep, 2020, 47(1):753-770.
[5] Alavi NM, Khademalhoseini S, Vakili Z, et al. Effect of vitamin D supplementation on depression in elderly patients: A randomized clinical trial[J]. Clin Nutr, 2019, 38(5):2065-2070.
[6] Shi Y, Song R, Wang L, et al. Identifying plasma biomarkers with high specificity for major depressive disorder: A multi-level proteomics study[J]. J Affect Disord, 2020, 277(12):620-630.
[7] 邓秉权, 李屾森, 邢红霞, 等. 维生素D结合蛋白研究新进展[J]. 中国血液净化, 2020, 19(9):634-636.
Deng BQ, Li SS, Xing HX, et al. Advances in the research of vitamin D binding protein[J]. Chin J Blood Purif, 2020, 19(9):634-636.
[8] First MB, Reed GM, Hyman SE, et al. The development of the ICD-11 clinical descriptions and diagnostic guidelines for mental and behavioural disorders[J]. World Psychiatry, 2015, 14(1):82-90.
[9] Pies RW. Antidepressants, the Hamilton Depression Rating Scale conundrum, and quality of life[J]. J Clin Psychopharmacol, 2020, 40(4):339-341.
[10] Furukawa TA. Adolescent depression: From symptoms to individualised treatment[J]. Lancet Psychiatry, 2020, 7(4):295-296.
[11] Höltge J, Theron L, Ungar M. A multisystemic perspective on the temporal interplay between adolescent depression and resilience-supporting individual and social resources[J]. J Affect Disord, 2022, 297(1):225-232.
[12] 张京婧, 朱道民, 张玉, 等. 抑郁症病人维生素D和C反应蛋白与糖脂代谢的相关性[J]. 安徽医药, 2020, 24(6):1121-1126.
Zhang JJ, Zhu DM, Zhang Y, et al. Correlation between vitamin D and C reactive protein and glucose and lipid metabolism in patients with depression[J]. Anhui Med Pharm J, 2020, 24(6):1121-1126.
[13] Charoenngam N, Holick MF. Immunologic effects of vitamin D on human health and disease[J]. Nutrients, 2020, 12(7):2097-2103.
[14] Mohammadzadeh I, Darvish S, Qujeq D, et al. Association of serum 25-OH vitamin D3 with serum IgE and the Pediatric Asthma Severity Score in patients with pediatric asthma[J]. Allergy Asthma Proc, 2020, 41(2):126-133.
[15] 赵磊, 李会林, 闻公灵, 等. 丙戊酸钠联合利培酮对癫痫性精神障碍患者血清25(OH)D3糖脂代谢及睡眠质量的影响[J]. 国际精神病学杂志, 2020, 47(5):964-967.
Zhao L, Li HL, Wen GL, et al. Effects of sodium valproate combined with risperidone on serum 25 (OH) D3
glucose and lipid metabolism and sleep quality in patients with epileptic mental disorder[J]. J Int Psychi, 2020, 47(5):964-967.
[16] 罗庆新, 陈凯婷, 蓝燕玲, 等. 25-羟基维生素D3在抑郁症治疗过程中的加成作用分析[J]. 检验医学, 2018, 33(6):491-494.
Luo QX, Chen KT, Lan YL, et al. Additive effect of serum 25-hydroxyvitamin D3 in the treatment of depression[J]. Lab Med, 2018, 33(6):491-494.
[17] 徐静, 史九波, 张凤岐, 等. 血清C-反应蛋白、白蛋白、前白蛋白、肿瘤坏死因子-α水平与抑郁症患者HAMD评分的关系[J]. 国际精神病学杂志, 2020, 47(4):682-685.
Xu J, Shi JB, Zhang FQ, et al. Correlation of the level of serum C-reactive protein, albumin, prealbumin and necrosis factor-α and HAMD scores in patients with depression[J]. J Int Psychi, 2020, 47(4):682-685.
[18] Dimova R, Chakarova N, Kirilov G, et al. Vitamin D binding protein is related to cardiac autonomic function and metabolic status in prediabetes[J]. Nutr Res, 2020, 75(1):56-66.
[19] Lisowska-Myjak B, Jóźwiak-Kisielewska A, Łukaszkiewicz J, et al. Vitamin D-binding protein as a biomarker to confirm specific clinical diagnoses[J]. Expert Rev Mol Diagn, 2020, 20(1):49-56.
[20] Wang M, Wang M, Zhang R, et al. Influences of vitamin D levels and vitamin D-binding protein polymorphisms on nonalcoholic fatty liver disease risk in a Chinese population[J]. Ann Nutr Metab, 2022, 78(2):61-72.
[21] Petrov B, Aldoori A, James C, et al. Bipolar disorder in youth is associated with increased levels of vitamin D-binding protein[J]. Transl Psychiatry, 2018, 8(1):61-67.
基金
河北省医学科学研究课题计划项目(20191389);秦皇岛市科学技术研究与发展计划项目(202004A094)
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