重性抑郁障碍患者肠道菌群特征及其与睡眠质量的相关性分析

Characteristics of gut microbiota and its correlation with sleep quality in patients with major depressive disorder

目的探讨重性抑郁障碍患者的肠道菌群特征,分析肠道菌群与抑郁症状、睡眠症状的相关性,为重性抑郁障碍伴睡眠问题的病理生理机制提供理论支持。方法本研究纳入重性抑郁障碍患者109例(MDD组)及健康被试96例(HC组),使用汉密尔顿抑郁量表(HAMD-17)和匹兹堡睡眠质量指数量表(PSQI)评估两组的抑郁症状和睡眠质量,采集两组粪便样本,使用16S rRNA测序方法对其分析,并采用Spearman相关性分析分析肠道菌群与抑郁症状、睡眠症状的相关性。结果MDD组HAMD评分(t=33.040,P<0.001)和PSQI评分(t=21.421,P<0.001)明显高于HC组。两组的Simpson指数、Pielou’s evenness指数存在差异(Z=2.178,P=0.029;Z=2.258,P=0.024)。PCoA分析显示,两组菌群未见明显差异(P<0.05)。LEfSe分析显示,MDD组肠道菌群以双歧杆菌属和布劳特菌属为主要优势菌属。相关性分析显示HAMD总分、PSQI总分及部分因子分与布劳特菌属和双歧杆菌属呈正相关,与拟杆菌属和罗氏菌属呈负相关。结论重性抑郁障碍患者的肠道菌群发生改变,其与抑郁症状及睡眠症状相关。

Objective To explore the characteristics of gut microbiota in patients with major depressive disorder(MDD),and analyze the correlation of disordered gut microbiota with depressive symptoms and sleep symptoms,so as to provide theoretical support for the pathophysiological mechanism of MDD with sleep problems.Methods One hundred and nine patients with MDD and 96 healthy controls(HCs)were enrolled in this study.Hamilton Depression Scale(HAMD-17)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate the depressive symptoms and sleep quality of the two groups.Stool samples of the two groups were collected and analyzed with 16S rRNA sequencing.Spearman correlation analysis was used to analyze the correlation of gut microbiota with depressive symptoms and sleep symptoms.Results The HAMD score(t=33.040,P<0.001)and PSQI score(t=21.421,P<0.001)were significantly higher in the MDD group than in the HC group.Simpson's index and Pielou's evenness index differed between the two groups(Z=2.178,P=0.029;Z=2.258,P=0.024).The PCoA showed no differences in the flora between the two groups.LEfSe analysis showed that Bifidobacterium and Blautia were the predominant genera in the MDD group.Correlation analysis showed that HAMD total score,PSQI total score and some factor scores were positively correlated with Blautia and Bifidobacterium and negatively correlated with Bacteroides and Roseburia.Conclusion Gut microbiota is altered in patients with MDD,which correlates with depressive symptoms and sleep symptoms.