不孕不育患者抑郁情绪与甲状腺激素、同型半胱氨酸水平的性别异质性研究

Study on the gender heterogeneity of depression and thyroid hormone and homocysteine levels in infertile patients

目的研究不孕不育患者抑郁情绪与甲状腺激素、同型半胱氨酸(Hcy)水平的性别异质性。方法将2017年1月至2020年9月在上海嘉定区妇幼保健院就诊的100例女性不孕症患者和100例男性不育症患者纳入研究,分别设置为女性组与男性组。采用抑郁自评量表(SDS)评估抑郁情绪,采用化学发光免疫法测定甲状腺激素和Hcy水平。比较女性组与男性组患者的抑郁评分、抑郁情绪发生率、甲状腺激素和Hcy水平。根据患者是否出现抑郁情绪,将女性组、男性组分别分为女性抑郁组与女性无抑郁组、男性抑郁组与男性无抑郁组,比较以上各组患者的甲状腺激素和Hcy水平,采用Spearman相关性系数分析法分析抑郁评分与甲状腺激素和Hcy水平的相关性。结果女性组与男性组患者的SDS评分、抑郁情绪发生率比较差异均无统计学意义(P>0.05);女性组患者的三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)和Hcy水平明显低于男性组,TSH水平明显高于男性组,差异均有统计学意义(P<0.05);SDS评分与TSH、Hcy呈正相关(P<0.05),与T3、T4呈负相关(P<0.05);男性抑郁组患者的T3、T4和Hcy水平明显高于女性抑郁组,TSH水平明显低于女性抑郁组,差异均有统计学意义(P<0.05);男性无抑郁组的T3、T4和Hcy水平明显高于女性无抑郁组,TSH水平明显低于女性无抑郁组,差异均有统计学意义(P<0.05)。结论不孕不育患者的甲状腺激素、Hcy水平在不同性别之间存在差异,其表达差异与抑郁情绪有关,临床上治疗不孕不育时应重视性别异质性。

Objective To explore the gender heterogeneity of depression and thyroid hormone and Homocysteine(Hcy) levels in infertile patients. Methods From January 2017 to September 2020, 100 females of infertility and 100 males of infertility in Shanghai Jiading Maternal Child Health Hospital were included in the study, which were divided into female group and male group, respectively. Self-rating Depression Scale(SDS) was used to evaluate whether the patients were depressed, and the levels of thyroid hormone and Hcy were measured by chemiluminescence immunoassay. The depression score, incidence of depression, thyroid hormone level, and Hcy level were compared between female group and male group. According to whether patients have depression, female and male groups were divided into female depression group and female non-depression group, male depression group and male non-depression group. The levels of thyroid hormone and Hcy were compared between female depression group and female non-depression group. Spearman correlation coefficient analysis was used to analyze the correlation between depression score and thyroid hormone and Hcy levels. Results There was no significant difference in SDS score and incidence of depression between female group and male group(P>0.05). T3, T4, and Hcy level in female group were significantly lower than those in male group(P<0.05), and TSH level in female group was significantly higher than that in male group(P<0.05). SDS score was positively correlated with TSH and Hcy, while SDS score was negatively correlated with T3 and T4. The level of T3, T4, and Hcy in male depression group were significantly higher than those in female depression group, and the level of TSH in male depression group was significantly lower than that in female depression group(P<0.05). The level of T3,T4, and Hcy in male non-depression group were significantly higher than those in female non-depression group, and TSH level in male non-depression group was significantly lower than that in female non-depression group(P<0.05).Conclusion The levels of thyroid hormone and Hcy in infertile patients are different between different genders, and their expression differences are related to depression. Attention should be paid to gender heterogeneity when treating infertility clinically.