重度抑郁症伴肥胖患者的血清CRP水平与认知功能的相关性及中介效应分析

Correlation and mediation effect of serum CRP level and cognitive function in major depression patients with obesity

目的分析重度抑郁症(major depressive disorder,MDD)伴肥胖患者的血清C-反应蛋白(C-reactive protein,CRP)水平与认知功能的关系,并探究血清CRP在BMI和认知功能之间是否具有中介效应。方法选取2022年12月~2023年6月于潍坊市精神卫生中心收治的MDD患者82名,按照是否伴有肥胖分组,观察组(合并肥胖)40人,对照组(不伴肥胖)42人,对两组分别进行血清CRP水平检测。分别采用汉密尔顿抑郁量表17项(Hamilton Depression Srale,HAMD-17)评估患者抑郁程度,蒙特利尔认知评估量表中文版(Montreal Cognitive Assessment,MoCA)评估患者认知功能,分析观察组血清CRP水平与认知功能的相关性并探究血清CRP在BMI和认知功能之间是否具有中介效应。结果观察组血清CRP水平高于对照组(P<0.05),观察组MoCA总分,视空间执行功能,延迟回忆分均低于对照组(P<0.05),相关性分析显示,血清CRP水平与MoCA总分,视空间执行功能,注意及延迟回忆评分均呈显著负相关(P<0.05),中介效应分析结果显示,血清CRP在BMI与延迟回忆之间起部分中介作用。结论伴肥胖的MDD患者血清CRP水平高于不伴有肥胖的MDD患者,血清CRP水平与认知功能呈负相关,并可能部分介导BMI与延迟回忆之间的关系。

Objective To analyze the relationship between serum C-reactive protein(CRP)level and cognitive function in patients with major depressive disorder(MDD)and obesity,and to explore whether serum CRP has a mediating effect between BMI and cognitive function.Methods A total of 82 MDD patients admitted to Weifang Mental Health Center from December 2022 to June 2023 were selected,and divided into two groups according to whether they were accompanied by obesity,40 in the observation group(combined with obesity)and 42 in the control group(without obesity).Serum CRP levels were detected in the two groups,respectively.The Hamilton Depression Scale(HAMD-17)was used to assess the degree of depression,and the Chinese version of the Montreal Cognitive Assessment Scale(MoCA)was used to assess the cognitive function of the patients.The correlation between serum CRP level and cognitive function in the observation group was analyzed,and the mediating effect of serum CRP on BMI and cognitive function was explored.Results The serum CRP level in the observation group was higher than that in the control group(P<0.05),and the total score of MoCA,visuospatial executive function and delayed recall score in the observation group were lower than those in the control group(P<0.05).Serum CRP level was significantly negatively correlated with MoCA total score,visuospatial executive function,attention and delayed recall score(P<0.05).The results of mediation effect analysis showed that serum CRP played a partial mediating role between BMI and delayed recall.Conclusion The serum CRP level of MDD patients with obesity is higher than that of MDD patients without obesity.The serum CRP level is negatively correlated with cognitive function,and may partially mediate the relationship between BMI and delayed recall.