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
{"title":"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。","authors":"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","doi":"10.1111/appy.12552","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Compared to HCs, the ghrelin levels were higher in the MDD (<i>p</i> < .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 (<i>r</i> = .867, <i>p</i> < .001), adrenocorticotropic hormone (ACTH) levels (<i>r</i> = .830, <i>p</i> < .001), and cortisol levels (<i>r</i> = .902, <i>p</i> < .001) in partial correlation analysis. In addition, there was a positive correlation between HAMD total score and ghrelin levels (<i>r</i> = .240, <i>p</i> = .026). Other than that, the HAMD total score also had a positive correlation with the CRH (<i>r</i> = .333, <i>p</i> = .002) and cortisol (<i>r</i> = .307, <i>p</i> = .004) levels. Further mediation analysis demonstrated that the relationship between ghrelin and HAMD total score was mediated by CRH (ab-path; <i>β</i> = .4457, 95% CI = 0.0780–1.0253, c-path; <i>β</i> = .2447, <i>p</i> = .0260, c′-path; <i>β</i> = −.2009, <i>p</i> = .3427).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"16 1","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ghrelin and depressive symptoms in patients with first-episode drug-naïve major depressive disorder: The mediating role of hypothalamic-pituitary-adrenal axis\",\"authors\":\"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\",\"doi\":\"10.1111/appy.12552\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Compared to HCs, the ghrelin levels were higher in the MDD (<i>p</i> < .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 (<i>r</i> = .867, <i>p</i> < .001), adrenocorticotropic hormone (ACTH) levels (<i>r</i> = .830, <i>p</i> < .001), and cortisol levels (<i>r</i> = .902, <i>p</i> < .001) in partial correlation analysis. In addition, there was a positive correlation between HAMD total score and ghrelin levels (<i>r</i> = .240, <i>p</i> = .026). Other than that, the HAMD total score also had a positive correlation with the CRH (<i>r</i> = .333, <i>p</i> = .002) and cortisol (<i>r</i> = .307, <i>p</i> = .004) levels. Further mediation analysis demonstrated that the relationship between ghrelin and HAMD total score was mediated by CRH (ab-path; <i>β</i> = .4457, 95% CI = 0.0780–1.0253, c-path; <i>β</i> = .2447, <i>p</i> = .0260, c′-path; <i>β</i> = −.2009, <i>p</i> = .3427).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":8618,\"journal\":{\"name\":\"Asia‐Pacific Psychiatry\",\"volume\":\"16 1\",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-02-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia‐Pacific Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/appy.12552\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia‐Pacific Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/appy.12552","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Ghrelin and depressive symptoms in patients with first-episode drug-naïve major depressive disorder: The mediating role of hypothalamic-pituitary-adrenal axis
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.
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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