瘦素与产后抑郁症状的相关性研究

Association between leptin and postpartum depression

目的探讨血清瘦素水平与产后抑郁症状的关系。方法收集200名待产孕妇,应用酶联免疫分析法(enzyme-linked immunosorbent assay,ELISA)测定其产前血清瘦素水平,在产后3 d采用爱丁堡产后抑郁量表(Edinburg postnatal depression scale,EPDS)调查其抑郁状况,产后42 d采用电话随访再次评估EPDS情况。分别将产后3 d和产后42 d EPDS得分≥13分者作为有产后抑郁症状组。结果产后3 d有抑郁症状组(52例)和对照组(148例)产前血清瘦素含量[M(QL,QU)]分别为1.36(1.15,1.68)μg/L和1.49(1.28, 1.91)μg/L,经正态转换后比较,有抑郁症状组低于对照组(P=0.021)。产后42 d有抑郁症状组(30例)和对照组(164例)产前血清瘦素含量[M(QL,QU)]分别为1.17(1.01,1.36)μg/L和1.50(1.29,1.90)μg/L,经正态转换后比较,有抑郁症状组低于对照组(P<0.001)。产后3 d(r=-0.199,P=0.014)、产后42 d(r=-0.254,P=0.002)EPDS得分分别与产前血清瘦素含量呈负相关。多因素logistic回归分析显示,瘦素水平与产后42 d抑郁症状有关联(OR=0.026,P=0.001)。结论产前血清瘦素水平下降可能与产后抑郁症状有关,高水平瘦素是产后抑郁症状的保护因素。

Objective This study aims to examine the association between leptin and postpartum depression symptoms. Methods Two hundred pregnant women were enrolled and their prenatal serum leptin levels were measured by using enzyme-linked immunosorbent assay (ELISA). The state of depression was first assessed on the third day after delivery and reassessed by a telephone follow up on the 42nd day using the Edinburg postnatal depression scale (EPDS) after delivery. Patients with postpartum depression symptoms with EPDS score ≥13 points after 3 days postpartum or 42 days postpartum were recruited as the depressive symptom group. Results The medians and lower and upper quartiles of the prenatal serum leptin levels in the depressive symptom group (the 3rd day) and the control group were 1.36 (1.15, 1.68)μg/L and 1.49 (1.28, 1.91)μg/L, respectively. After normal conversion, the serum leptin level was significantly lower in the depressive symptom group than in the control group (P=0.021). The medians and lower and upper quartiles of the prenatal serum leptin levels in the depressive symptom group (the 42nd day) and the control group were 1.17 (1.01, 1.36)μg/L and 1.50 (1.29, 1.90)μg/L, respectively. After normal conversion, the serum leptin level was significantly lower in the depressive symptom group than in the control group (P<0.001). EPDS scores 3 days postpartum (r=-0.199, P=0.014) and 42 days postpartum (r=-0.254, P=0.002) were negatively correlated with prenatal serum leptin levels. Multiple logistic regression analysis showed that the prenatal leptin levels were associated with depressive symptoms at 42 days postpartum (OR=0.026, P=0.001). Conclusion Prenatal serum leptin levels may be associated with postpartum depressive symptoms, and high levels of leptin are protective factors for postpartum depression.