抑郁症患者血清短链脂肪酸水平与症状及生化指标的相关性

Correlation of serum short-chain fatty acid levels with symptoms and biochemical indicators in patients with depression

目的 探索抑郁症患者血清短链脂肪酸与生化指标及症状的相关性。方法 本研究共纳入50例住院的抑郁症患者为病例组,并同期海报招募了42名健康志愿者为对照组。采用气相色质谱法检测所有被试者血清中5种短链脂肪酸含量,包括乙酸、丁酸、戊酸、异戊酸和己酸。采用ELISA法检测血脂、血糖、胆汁酸、肌酐、尿素、尿酸、甲状腺素等生化指标。采用流式细胞法检测血液中的免疫指标(白细胞、中性粒细胞、淋巴细胞、单核细胞、中性粒细胞百分比、淋巴细胞百分比、单核细胞百分比)。采用HAMD-17、HAMA-14他评量表以及PHQ-9、GAD-7、PSQI、SDS等自评量表评估抑郁症的临床症状。使用Spearman相关分析计算短链脂肪酸与血液免疫细胞、血糖血脂、甲状腺素等生化指标和临床症状量表的相关性。结果 病例组血清短链脂肪酸中乙酸、戊酸、异戊酸含量显著高于对照组(P<0.05)。相关性分析表明,在抑郁症患者中升高的乙酸与单核细胞百分比呈显著正相关(r=0.39,P<0.01);戊酸与尿酸呈负相关(r=-0.33,P<0.05),与葡萄糖(r=0.31,P<0.05)和GAD7(r=0.31,P<0.05)呈正相关;异戊酸与肌酐(r=0.29,P<0.05)、尿素(r=0.30,P<0.05)、HAMA中的精神焦虑因子(r=0.28,P<0.05)均呈正相关;丁酸与TSH呈正相关(r=0.34,P<0.05),与淋巴细胞数量呈负相关(r=-0.39,P<0.01);己酸与甘油三酯(r=0.36,P<0.05)、总胆固醇(r=0.42,P<0.01)、低密度脂蛋白(r=0.42,P<0.01)、HAMD中睡眠因子(r=0.30,P<0.05)均呈正相关。结论 抑郁症患者血清短链脂肪酸中乙酸、戊酸、异戊酸水平升高,可能与血糖、血脂、血常规、甲状腺功能相互作用,共同对抑郁症的发生产生影响。

Objective To investigate the correlation between serum short-chain fatty acid levels and biochemical indicators,clinical symptoms in patients with depression.Methods A total of 50 hospitalized patients with depression were enrolled in this study as case group,and 42 healthy volunteers were recruited as control group via posters at the same period.Gas chromatography mass spectrometry was used to detect the contents of five short-chain fatty acids in the serum,including acetic acid,butyric acid,valeric acid,isovaleric acid and caproic acid.ELISA method was used to detect biochemical indicators such as blood lipids,blood sugar,bile acids,creatinine,urea,uric acid,and thyroxine.Flow cytometry was used to detect immune indicators in the blood,including white blood cells,neutrophils,lymphocytes,monocytes,neutrophil percentage,lymphocyte percentage,and monocyte percentage.Clinical symptoms of depression patients were assessed using HAMD-17,HAMA-14 examiner-rating scales and self-rating scales such as PHQ-9,GAD-7,PSQI,and SDS.Spearman correlation analysis was used to analyze the correlation between short-chain fatty acids and biochemical indicators such as blood immune cells,blood glucose and lipids,and thyroxine,and clinical scales.Results Serum levels of acetic acid,valeric acid,and isovaleric acid were significantly higher in case group than in control group(P<0.05).Elevated acetate was significantly positively correlated with monocyte percentage in patients with depression(r=0.39,P<0.01).Valeric acid was negatively correlated with uric acid(r=-0.33,P<0.05),and positively correlated with glucose(r=0.31,P<0.05)and GAD7(r=0.31,P<0.05).Isovaleric acid was positively correlated with creatinine(r=0.29,P<0.05),urea(r=0.30,P<0.05)and mental anxiety factor in HAMA(r=0.28,P<0.05).Butyrate was positively correlated with TSH(r=0.34,P<0.05),and negatively correlated with the number of lymphocytes(r=-0.39,P<0.01).Caproic acid was positively correlated with multiple lipid metabolism parameters such as triglycerides(r=0.36,P<0.05),total cholesterol(r=0.42,P<0.01),and low-density lipoprotein(r=0.42,P<0.01)and sleep factor in HAMD(r=0.30,P<0.05).Conclusion The levels of acetic acid,valeric acid,and isovaleric acid in serum of patients with depression are increased,which may interact with blood sugar,blood lipids,blood routine,and thyroid function to jointly affect the occurrence of depression.