抑郁症患者的代谢负荷和代谢综合征:横断面分析

IF 4.7 2区 医学 Q1 PSYCHIATRY Depression and Anxiety Pub Date : 2024-06-05 DOI:10.1155/2024/1355340
Francis Osei, Pia-Maria Wippert, Andrea Block
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引用次数: 0

摘要

静态负荷(Allostatic load,AL)是指长期不良的生理或社会心理状况对身体造成的累积性磨损。急性应激反应会激活 AL 的主要介质,包括皮质醇、肾上腺素(EPI)、去甲肾上腺素(NE)和硫酸脱氢表雄酮(DHEA-S)。长期应激反应可导致代谢综合征(MetS)、心血管和免疫系统变化等次要结果。鉴于对急性应激源的这些复杂反应,在实验环境中调查个体应激反应时需要进行多维度的应激评估。本研究旨在探讨重度抑郁症(MDD)患者体内 AL 的主要介质与 MetS 之间的关联。研究人员对患有 MetS+(46 人,体重为 93.10 ± 16.43 千克)和未患有 MetS-(118 人,体重为 73.08 ± 15.22 千克)的 MDD 患者(164 人,年龄为 18-65 岁)进行了横截面分析。采用逐步二元回归和韦尔奇 t 检验来发现两组之间的关联和差异。回归分析对年龄、性别和贝克抑郁量表-II 评分进行了充分调整。在未经调整的模型中,皮质醇(b = -0.003,p = 0.034)与 MetS 呈反向关系。在完全调整模型中,EPI(b = -0.006,p = 0.007)与 MetS 成反比。然而,在皮质醇方面,未患 MetS- 的 MDD 患者(410.13 ± 144.63 nmol/l)和患 MetS+ 的 MDD 患者(340.90 ± 132.98 nmol/l)之间存在明显差异(p = 0.005),但影响较小(Cohen's d 为 0.489)。未患 MetS- 的 MDD 患者(185.67 ± 124.44 pg/ml)和患 MetS+ 的 MDD 患者(124.95 ± 84.38 pg/ml)之间的 EPI 存在显著差异(p = 0.001),效应大小适中(Cohen's d 为 0.530)。这些观察结果对 MDD 患者的管理具有重要的临床意义。
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Allostatic Load and Metabolic Syndrome in Depressed Patients: A Cross-Sectional Analysis

Allostatic load (AL) is the cumulative wear and tear on the body due to the chronic adverse physical or psychosocial situations. The acute stress response activates the primary mediators of AL, which include cortisol, epinephrine (EPI), norepinephrine (NE), and dehydroepiandrosterone sulfate (DHEA-S). Secondary outcomes, such as metabolic syndrome (MetS), cardiovascular, and immune system changes, can result from long-term stress responses. Given these complex reactions to an acute stressor, a multidimensional stress assessment is required when investigating individual stress reactivity in an experimental setting. This study is aimed at examining the association between the primary mediators of AL and MetS in major depressive disorder (MDD) patients. MDD patients (n = 164, age = 18–65 years old) with MetS+ (n = 46, weight = 93.10 ± 16.43 kg) and without MetS- (n = 118, weight = 73.08 ± 15.22 kg) were analyzed cross-sectionally. Stepwise binary regression and Welch’s t-test were used to find the associations and differences between the two groups. The regression analysis was fully adjusted for age, sex, and the Beck Depression Inventory-II score. In unadjusted model, cortisol (b = −0.003, p = 0.034) was inversely associated with MetS. In fully adjusted model, EPI (b = −0.006, p = 0.007) was inversely associated with MetS. However, significant differences (p = 0.005) were observed for cortisol between MDD patients without MetS- (410.13 ± 144.63 nmol/l) and MDD patients with MetS+ (340.90 ± 132.98 nmol/l) with a small effect size (Cohen’s d of 0.489). Significant differences (p = 0.001) were observed for EPI between MDD patients without MetS- (185.67 ± 124.44 pg/ml) and MDD patients with MetS+ (124.95 ± 84.38 pg/ml) with a moderate effect size (Cohen’s d of 0.530). These observations are of clinical importance for the management of MDD patients.

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来源期刊
Depression and Anxiety
Depression and Anxiety 医学-精神病学
CiteScore
15.00
自引率
1.40%
发文量
81
审稿时长
4-8 weeks
期刊介绍: Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.
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