首发精神疾病患者性激素水平的横断面比较

Cross-sectional comparison of sex hormone levels in patients with first episode mental illness

目的比较常见首发精神疾病基线期性激素水平的差异。方法回顾性调查2012年1月至2017年12月在苏州市广济医院住院的514例首发精神疾病患者,其中精神分裂症患者226例,双相情感障碍患者90例,抑郁症患者198例,收集人口学资料及基线期各组患者的黄体生成素(LH2)、卵泡刺激素(FSH)、泌乳素(PRL)、雌二醇(E2)和睾酮(TES)水平,采用多重Logistic回归控制混杂因素,分析比较3组患者性激素分泌的差异。结果在多因素调整前,首发精神分裂症与抑郁症患者之间的LH2、FSH、PRL、E2、TES水平差异均有统计学意义(P<0.05),双相情感障碍与抑郁症患者之间只有PRL水平差异有统计学意义(P=0.027),精神分裂症与双相情感障碍患者的5种性激素水平比较,差异均无统计学意义(P>0.05)。在多因素调整后的回归模型中,将5种性激素作为连续变量分析显示,3组首发精神疾病患者之间各类性激素水平比较,差异均无统计学意义(P>0.05);但将5种性激素作为分类变量分析,精神分裂症较抑郁症患者更易出现PRL(OR=2.038,95%CI=1.250~3.324,P=0.004)、TES(OR=2.015,95%CI=1.024~3.964,P=0.042)的分泌异常,双相情感障碍较抑郁症患者更易出现PRL分泌异常(OR=1.996,95%CI=1.103~3.611,P=0.022)。结论各类性激素水平在3种常见首发精神疾病间无显著差别,但相较于抑郁症,精神分裂症患者更易出现PRL、TES的分泌异常,双相情感障碍患者更可能出现PRL的分泌异常。

Objective To compare the differences in sex hormone levels among common first-episode psychiatric diseases at baseline.Methods A retrospective survey of 514 inpatients from Suzhou Guangji Hospital with first-episode psychiatric diseases from January 2012 to December 2017 was conducted.Among which,there were 266 schizophrenia patients,95 bipolar disorder patients and 198 depression patients.Demographic data and the baseline levels of luteinizing hormone(LH2),follicle stimulating hormone(FSH),prolactin(PRL),estrogen(E2)and testosterone(TES)were collected.Multiple logistic regression was used to control the confounding factors,and the differences of sex hormone secretion among the three groups were analyzed and compared.Results Before multi-factor adjustment,there were statistical differences LH2,FSH,PRL,E2 and TES between first-episode schizophrenia and depression(P<0.05);there was only significant difference in PRL level between patients with bipolar disorder and depression(P=0.027);there was no significant difference in the levels of five sex hormones between patients with schizophrenia and bipolar disorder(P>0.05).In the multivariate adjusted regression model,the analysis of five sex hormones as continuous variables showed that there was no significant difference in the levels of various sex hormones among the three groups(P>0.05).Taking five sex hormones as categorical variables,schizophrenia is more likely to have abnormal secretion of PRL(OR=2.038,95%CI=1.250-3.324,P=0.004)and TES(OR=2.015,95%CI=1.024-3.964,P=0.042)than depression,and bipolar disorder is more likely to have abnormal secretion of PRL(OR=1.996,95%CI=1.103-3.611,P=0.022)than depression.Conclusions There was no significant difference in the levels of various sex hormones among the three common first-episode psychiatric diseases,but compared with depression,patients with schizophrenia were more likely to have abnormal secretion of PRL and TES,and patients with bipolar disorder were more likely to have abnormal secretion of PRL.