25-羟基维生素D3与口腔扁平苔藓共患焦虑抑郁的相关性研究

Relationship betwecn 25-hydroxyvitamin D3 and comorbid anxiety and depression in oral lichen planus

目的探究25-羟基维生素D3[25(OH)D_(3)]与口腔扁平苔藓(OLP)患者共患焦虑和抑郁的相关性。方法选取2022年1月—2023年12月就诊于徐州市第一人民医院的127例OLP患者(OLP组),另选择同期122例健康体检者作为对照(对照组),收集所有患者的基线资料。采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)对2组患者焦虑和抑郁情况进行评分,通过Spearman相关性分析评价其与血清25(OH)D_(3)水平的关系,采用logistic回归分析评价OLP患者焦虑和抑郁发生的相关因素。结果OLP组患者血清25(OH)D_(3)水平低于对照组,HAMA和HAMD评分高于对照组,差异均有统计学意义(P<0.05)。OLP患者中有77例(60.63%)同时出现焦虑和抑郁(共患焦虑抑郁组),50例(39.37%)未同时出现焦虑和抑郁(非共患焦虑抑郁组)。2组OLP患者的病程,网纹、红斑、溃疡(REU)评分系统总REU评分,视觉模拟量表(VAS)评分差异均有统计学意义(P<0.05)。Spearman相关性分析发现,血清25(OH)D_(3)水平与HAMA评分(r=-0.421,P<0.001)、HAMD评分(r=-0.473,P<0.001)均呈负相关。多元logistic回归结果显示,OLP患者的总REU评分、VAS评分、血清25(OH)D_(3)水平与同时合并焦虑和抑郁的发生相关。结论OLP患者低血清25(OH)D_(3)水平与其是否共患焦虑和抑郁症状有关。建议临床医生关注OLP患者的心理状态,尤其关注低血清25(OH)D_(3)水平的患者是否出现焦虑和抑郁症状。

Objective To investigate the relationship between 25-hydroxyvitamin D_(3)[25(OH)D_(3)]and comorbid anxiety and depression in patients with oral lichen planus(OLP).Methods A total of 127 patients with OLP who were admitted to the First People′s Hospital of Xuzhou from January 2022 to December 2023 were selected and set as an OLP group.Another 122 healthy subjects for physical examination during the same period were chosen and set as a control group.Their baseline data were collected.Furthermore,the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)scores were evaluated to compare the anxiety and depression of patients in the two groups,and their relationship with serum 25(OH)D_(3)levels was analyzed by Spearman correlation analysis.The logistic regression analysis was used to evaluate the factors associated with the anxiety and depression in OLP patients.Results The OLP patients showed lower serum 25(OH)D_(3)levels but higher HAMA and HAMD scores than healthy controls,with statistical differences(P<0.05).Among the OLP patients,77 patients(60.63%)simultaneously presented both anxiety and depression(the comorbid anxiety-depression group),and 50(39.37%)did not simultaneously present both anxiety and depression(the non-comorbid anxiety-depression group).Differences in disease duration,total reticulation,erythema and ulceration(REU)scores,and visual analog scale(VAS)scores between the two groups of OLP patients were statistically significant(P<0.05).Spearman correlation analysis indicated that serum 25(OH)D_(3)levels were negatively associated with HAMA scores(r=-0.421,P<0.001)and HAMD scores(r=-0.473,P<0.001).According to multivariate logistic regression analysis,total REU scores,VAS scores,and serum 25(OH)D_(3)levels in OLP patients were associated with the occurrence of comorbid anxiety and depression.Conclusions Low serum 25(OH)D_(3)levels in OLP patients are associated with comorbid anxiety and depressive symptoms.It is necessary for clinicians to pay attention to the psychological status of OLP patients,especially the presence of anxiety and depression symptoms in patients with low serum 25(OH)D_(3)levels.