Ghrelin and depressive symptoms in patients with first-episode drug-naïve major depressive disorder: The mediating role of hypothalamic-pituitary-adrenal axis

IF 2.8 3区医学 Q2 PSYCHIATRY Asia‐Pacific Psychiatry Pub Date : 2024-02-13 DOI:10.1111/appy.12552

Chuhao Zhang MSc, Yeqing Dong PhD, ShuHua Li PhD, Meijuan Li PhD, Ying Gao MSc, Yuan Liu PhD, Xueying Liu MSc, Chi Zhou MSc, Jie Li MD, PhD

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Abstract

Background

Major depressive disorder (MDD) is one of the global burdens of disease, and its pathogenesis remains unclear. An increasing amount of research indicates that ghrelin regulates mood in patients with MDD. Still, current results are inconsistent, and the mechanisms underlying how ghrelin modulates depressive symptoms are inconclusive, especially in first-episode drug-naïve MDD patients. Therefore, this study aims to investigate the relationship and potential mechanism between ghrelin and first-episode drug-naïve MDD.

Methods

Ninety first-episode drug-naïve MDD patients and 65 healthy controls (HCs) were included. Hamilton Depression Scale (HAMD-17) as a measure of depressive symptoms. Plasma levels of ghrelin and hypothalamic–pituitary–adrenal axis (HPA-axis) hormones were measured in all participants.

Results

Compared to HCs, the ghrelin levels were higher in the MDD (p < .001) and still showed significance after covarying for sex, age, and Body Mass Index (BMI). Ghrelin was positively related to corticotropin-releasing-hormone (CRH) levels (r = .867, p < .001), adrenocorticotropic hormone (ACTH) levels (r = .830, p < .001), and cortisol levels (r = .902, p < .001) in partial correlation analysis. In addition, there was a positive correlation between HAMD total score and ghrelin levels (r = .240, p = .026). Other than that, the HAMD total score also had a positive correlation with the CRH (r = .333, p = .002) and cortisol (r = .307, p = .004) levels. Further mediation analysis demonstrated that the relationship between ghrelin and HAMD total score was mediated by CRH (ab-path; β = .4457, 95% CI = 0.0780–1.0253, c-path; β = .2447, p = .0260, c′-path; β = −.2009, p = .3427).

Conclusions

These findings revealed that plasma ghrelin provides a pivotal link to depressive symptoms in first-episode drug-naive MDD patients. CRH mediated the relationship between ghrelin and HAMD total score. It might provide new insights into understanding the pathogenesis of MDD, contributing to intervention and treatment from this approach.

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胃泌素与初发药物治疗无效的重度抑郁症患者的抑郁症状：下丘脑-垂体-肾上腺轴的中介作用。

背景：重度抑郁障碍（MDD）是全球疾病负担之一，其发病机制仍不清楚。越来越多的研究表明，胃泌素能调节 MDD 患者的情绪。然而，目前的研究结果并不一致，胃泌素如何调节抑郁症状的机制也尚无定论，尤其是在初次发病且未接受药物治疗的 MDD 患者中。因此，本研究旨在探讨胃泌素与首次发病的药物治疗无效的MDD之间的关系和潜在机制：方法：纳入 90 名首次发病的药物治疗无效 MDD 患者和 65 名健康对照组（HCs）。用汉密尔顿抑郁量表（HAMD-17）测量抑郁症状。对所有参与者的胃泌素和下丘脑-垂体-肾上腺轴（HPA轴）激素的血浆水平进行了测量：结果：与普通人相比，MDD 患者的胃泌素水平更高（p 结论：MDD 患者的胃泌素水平高于普通人：这些研究结果表明，血浆胃泌素与首次发病、对药物过敏的 MDD 患者的抑郁症状有重要联系。CRH 介导了胃泌素与 HAMD 总分之间的关系。这可能为了解 MDD 的发病机制提供了新的见解，有助于从这一角度进行干预和治疗。

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来源期刊

Asia‐Pacific Psychiatry PSYCHIATRY-

CiteScore

7.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Asia-Pacific Psychiatry is an international psychiatric journal focused on the Asia and Pacific Rim region, and is the official journal of the Pacific Rim College of Psychiatrics. Asia-Pacific Psychiatry enables psychiatric and other mental health professionals in the region to share their research, education programs and clinical experience with a larger international readership. The journal offers a venue for high quality research for and from the region in the face of minimal international publication availability for authors concerned with the region. This includes findings highlighting the diversity in psychiatric behaviour, treatment and outcome related to social, ethnic, cultural and economic differences of the region. The journal publishes peer-reviewed articles and reviews, as well as clinically and educationally focused papers on regional best practices. Images, videos, a young psychiatrist''s corner, meeting reports, a journal club and contextual commentaries differentiate this journal from existing main stream psychiatry journals that are focused on other regions, or nationally focused within countries of Asia and the Pacific Rim.

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