脑源性神经营养因子血清浓度与双相障碍关系横断面研究(英文)

Cross-sectional study of the association between serum concentration of brain-derived neurotrophic factor and bipolar disorder

背景近年来发现,脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)的血清浓度与双相障碍症状关系的研究结果不一致。目的检验BDNF血清浓度与双相障碍的关系,并讨论双相障碍家族史在两者关系中的作用。方法 检测了228例双相障碍患者和153名健康对照者的BDNF血清浓度,采用杨氏躁狂量表和汉密尔顿抑郁量表(17项)评估患者的躁狂或抑郁症状,将杨氏躁狂量表评分≥20分定义为躁狂发作,共计85例;将汉密尔顿抑郁量表评分≥17分定义为抑郁发作,共计14例;将杨氏躁狂量表评分<20分并且汉密尔顿抑郁量表评分<17分定义为缓解期,共计129例。结果患者组平均(标准差)BDNF血清浓度低于健康对照组[18.75(8.98)ng/ml比23.72(5.60)ng/ml,t=6.09,P<0.001],且各个亚组(躁狂组、抑郁组和缓解期组)与健康对照组BDNF血清浓度的差异均有统计学意义。躁狂发作期与缓解期之间的BDNF血清浓度差异有统计学意义,其余各亚组间的差异无统计学意义。在多元线性回归模型中控制各个因素后,发现仅有杨氏躁狂量表评分与BDNF血清浓度呈正相关(标准回归系数=0.17,P=0.011)。结论双相障碍患者的BDNF血清浓度低于健康对照组,BDNF血清浓度与躁狂症状存在正相关,与是否存在家族史并不相关。

Background： Recent studies have reached different conclusions about the relationship of brain-derived neurotrophic factor （BDNF） and the symptoms of bipolar disorder.Objective： Examine the correlation between the serum concentration of 13DNF and bipolar disorder and consider whether or not family history of bipolar disorder mediates this relationship.Methods： Serum BDNF concentrations were measured in 228 patients with bipolar disorder and 153 normal con- trols. Patients with bipolar disorder were assessed using the Young Mania Rating Scale （YMRS） and the Hamilton Depression Rating Scale （HAMD-I 7）：85 with YMRS~〉20 were considered manic, 14 with HAMD≥ 17 were considered depressed, and 129 with YMRS 〈20 and HAMD 〈 17 were considered euthymic.Results： The mean （SD） concentration of BDNF in bipolar patients was significantly lower than that in the control group [ 18.75 （8.98） ng/ml vs. 23.72（5.60） ng/ml; t=6.09, P 〈0. 001 ], and this difference was present persisted in all three phases of bipolar illness （ manic, depressive, euthymic）. Moreover, serum BDNF was significantly higher in bipolar patients in the manic phase of illness than in those in the euthymic phase of illness. After controlling for all available variables in a multivariate regression model, the only factor significantly related to higher ser- um BDNF levels in bipolar patients was the YMRS score （ standardized regression coefficien =0.17, P =0.011 ）.Conclusion： The serum concentration of BDNF in bipolar patients is lower than that in normal controls and is posi- tively related to the severity of manic symptoms. It is not related to family history of bipolar disorder.