血浆酰基化Ghrelin水平变化与抑郁症的相关性

Clinical research of the correlation between plasma acylated ghrelin and depression

目的探讨血浆酰基化Ghrelin水平变化与抑郁症的相关性。方法纳入33例首诊抑郁症发作患者为抑郁症组,30例健康志愿者为对照组。比较抑郁症组治疗前与对照组血浆总ghrelin和酰基化ghrelin的水平。抑郁症组应用艾司西酞普兰治疗6个月,分别于治疗前和治疗后第6月末采用放射免疫法测定患者血浆总ghrelin和酰基化ghrelin的水平;以汉密尔顿抑郁量表(HAMD)评定症状的严重程度。结果抑郁症组患者治疗前血浆酰基化ghrelin水平低于对照组(P<0.05),抑郁症组患者经抗抑郁治疗后血浆酰基化ghrelin水平较治疗前升高(P<0.05);抑郁症组治疗前血浆总ghrelin水平与对照组比较差异无统计学意义(P>0.05),抑郁症组患者经抗抑郁治疗后血浆总ghrelin水平较治疗前无显著变化(P>0.05);Spearman显示治疗前血浆酰基化ghrelin浓度与HAMD评分呈负相关性(P<0.05),艾司西酞普兰治疗后,酰基化Ghrelin与HAMD无相关性(P>0.05);多元逐步回归分析显示HAMD评分和年龄是影响未治疗抑郁症患者酰基化ghrelin浓度的独立危险因素,年龄与酰基化ghrelin浓度呈正相关(P<0.05),HAMD评分与酰基化ghrelin浓度呈负相关(P<0.05)。结论抑郁症患者的血浆酰基化Ghrelin水平存在异常,治疗前酰基化Ghrelin越低抑郁症状越重,且与HAMD评分具有负相关性。艾司西酞普兰治疗后,抑郁症状改善,酰基化Ghrelin水平明显上升,但HAMD评分与酰基化ghrelin浓度间无相关性,提示可能多种机制参与了抑郁症患者治疗期间症状程度的改善。

Objective To research the correlation between plasma acylated ghrelin and depression.Methods Patients were eligible for the trial if they were first diagnosed with depression,as defined by criteria of DSM-IV.They were treafecl with escitalopram(daily dose of 10~20 mg of escitalopram for 6 months).The concentration of plasma total ghrelin and acylated ghrelin were determined by radio-immunoassay at the point of pre-and post-treatment.The severity of symptoms for patients was assessed by Hamilton depression scale(HAMD).Thirty healthy volunteers were classified into the control group.Results Before escitalopram treatment,the level of acylated ghrelin in depressive patients was lower than that of control group.However,after treatment,the plasma acylated ghrelin level was increased.No changes in total ghrelin levels of patients with depression were found at before and after treatment.Spearman correlation analysis showed that the plasma acylated ghrelin level was negatively correlated with the HAMD score at the baseline.No significant difference was found among the plasma acylated ghrelin leveland HAMD score after treatment.The age was positively correlated with acylated ghrelin level.Meanwhile HAMD was negatively correlated with acylated ghrelin level.Conclusion Decreased acylated ghrelin levels may be involved in the etiology of depressive disorders.The plasma acylated ghrelin levels are negatively correlated with the severity of depression before treatment.After the treatment of escitalopram,the HAMD score is ameliorated,and the acylatedghrelin level is obviously recovered as well.There are various mechanisms could be involved in the regulation of the expression of acylated ghrelin.