青少年抑郁症状与清晨觉醒唾液皮质醇水平的相关性  

Relationship between depressive symptoms and salivary awakening cortisol concentration in adolescents

作　　者：郭策 段晓楠[1] 来亚平[1] 胡晶晶[1] 徐耿[1] 孟秀红[1] 孙莹[1] GUO Ce;DUAN Xiaonan;LAI Yaping;HU Jingling;XU Geng;MENG Xiuhong;SUN Ying(Department of Maternal, Child ＆ Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Key Laboratory of Population Health＆Aristogenics, Hefei 230032, Chin)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/安徽省人口健康与优生省级重点实验室,合肥230032

出　　处：《中国学校卫生》2018年第4期540-542,545,共4页Chinese Journal of School Health

基　　金：国家自然科学基金面上项目(8167120176)

摘　　要：目的探讨青少年抑郁症状与清晨觉醒唾液皮质醇水平的关联,为青少年抑郁症状的有效防控提供参考。方法招募安徽省马鞍山市3所小学二至五年级学生共1 552名,收集其清晨即刻唾液,采用酶联免疫测定法测定皮质醇质量体积浓度;抑郁症状使用情绪与心境问卷量表评价,同时收集体力活动、视频时间、睡眠时间、父母文化程度、青春期发育情况、家庭经济状况等信息,并测量身高和体重。采用Logistic回归模型评价唾液皮质醇水平与抑郁症状的关联。结果青少年抑郁症状的检出率为16.4%,抑郁症状组皮质醇水平中位数(374.38 ng/mL)高于非抑郁症状组(339.42 ng/m L),差异有统计学意义(u=29.38,P<0.01)。控制性别、父母文化程度、家庭经济情况等混杂因素后,相比于皮质醇水平位于P_(25)~P_(75)组青少年,<P_(25)组青少年抑郁症状检出率较低(OR=0.52,95%CI=0.35~0.78),>P_(75)组青少年抑郁症状检出率较高(OR=1.47,95%CI=1.07~2.01)。结论青少年清晨唾液高水平皮质醇浓度与青少年抑郁症状检出率高度关联。Objective To investigate the association between depressive symptoms and early morning awakening salivary cortisol levels,and to provide reference for effectively controlling and preventing depressive symptoms among adolescents. Methods A total of 1 552 students in grade 3 to 5 from 3 primary schools in Ma’ an shan were recruited. Saliva was collected immediately on awakening. Cortisol concentration was analyzed by using enzyme-linked immunosorbent assay（ ELISA）. Depressive symptoms were assessed by Mood and Feelings Questionnaire-Child version（ MFQ-C）. Body mass index was calculated after physical examination.A questionnaire survey was conducted by collecting information on physical activity,screen time,sleep duration,parental education,pubertal development,as well as household economic status. Logistic regression model was used to evaluate the association between the depressive symptoms and salivary awakening cortisol concentration in adolescents. Results Among all the 861 boys and691 girls,the detection rate of depressive symptoms was 16.4%,the median cortisol concentration of depression group（ 374.38 ng/m L） was higher than that of non-depression group（ 339.42 ng/m L）,with statistical significance（ u = 29.38,P〈0.01）. Compared to cortisol concentration in P25-P75 group,adolescents with cortisol level ≤P25 group had lower rate of depressive symptoms（ OR =0.52,95%CI = 0.35-0.78）,adolescents with cortisol level ≥P75 group had higher rate of depressive symptoms（ OR = 1.47,95%CI= 1.07-2.01）. Conclusion High concentration of awakening cortisol in adolescents is associated with higher risk of adolescent depressive symptoms among adolescents.

关 键 词：抑郁 唾液分泌 回归分析 青少年 

分 类 号：R195[医药卫生—卫生统计学] R749.94[医药卫生—卫生事业管理]