帕金森病合并抑郁症与25-羟基维生素D的相关性研究  

Association between Parkinson’s disease combined with depression and 25-hydroxyvitamin D

作　　者：李星[1] 张保朝[1] 赵伟[1] 牛犇[1] 常利[2] LI Xing;ZHANG Baochao;ZHAO Wei(Department of Neurology,Hanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院神经内科,南阳473000 [2]新乡医学院第一附属医院神经内科

出　　处：《国际精神病学杂志》2020年第5期900-903,共4页Journal Of International Psychiatry

基　　金：河南省医学科技攻关计划项目(编号:201602175)。

摘　　要：目的探讨帕金森病(Parkinson disease,PD)合并抑郁症与25-羟基维生素D(25-hydroxyvitamin D,25-OH-VitD)的相关性。方法纳入我院神经内科85例PD患者作为PD组,63例PD合并抑郁症患者作为PDD组,55例健康人群作为对照组。采用酶联免疫吸附法(ELISA)检测并比较三组研究对象血清25-OH-VitD水平的差异,PDD组患者血清25-OH-VitD的影响因素采用Logistic分析,采用Pearson相关分析血清25-OH-VitD水平与其临床参数的相关性,25-OH-VitD水平在诊断PD合并抑郁症的临床效能采用受试者操作特征(Receiver operating characteristic,ROC)曲线分析。结果PD组患者25-OH-VitD水平为(23.54±3.68)ng/ml,同对照组(43.65±6.47)ng/ml相比显著降低(t=-23.419,P=0.000),但显著高于PDD组患者(15.43±2.65)ng/ml(t=14.862,P=0.000),差异均具有统计学意义。Logistic分析结果显示,PDD组患者的病程、UPDRS III评分、Hoehn-Yahr分级和HAMD评分是血清25-OH-VitD水平的影响因素(均P<0.05)。血清25-OHVitD水平与病程、UPDRS III和HAMD评分均呈显著负相关性,相关系数r分别为-0.697,-0.546和-0.640。25-OH-VitD水平在诊断PD合并抑郁症的临床效能显著,AUC为0.917,当截断值为18.38 ng/mL时敏感性和特异度分别为94.91%和90.23%。结论PD合并抑郁症患者血清25-OHVitD水平显著降低,PD并发抑郁症的发生可能与较低水平的25-OH-VitD有关,25-OH-VitD可作为诊断PD伴发抑郁症的生物学指标。Objective To investigate the association between Parkinson’s disease(PD)combined with depression and 25-hydroxyvitamin D.Methods A total of 85 patients with PD and 63 patients with PD combined with depression in the department of neurology in our hospital were included defined as PD group and PDD group,respectively.Others 55 healthy individuals defined as control group.The serum 25-hydroxyvitamin D levels among the three groups were detect by ELISA method and compared.The influencing factors of serum 25-hydroxyvitamin D levels and the correlation between clinical parameters in PDD group by Logistic and Pearson analysis,respectively.The clinical efficacy of 25-hydroxyvitamin D levels in the diagnosis of PD combined with depression was analyzed by Receiver operating characteristic(ROC)curve.Results The serum 25-hydroxyvitamin D levels in the PD group was significantly lower than the control group(23.54±3.68 vs.43.65±6.47,t=-23.419,P=0.000),but significantly higher than the PDD group(23.54±3.68 vs.15.43±2.65,t=14.862,P=0.000).The differences were statistically significant.Logistic analysis showed that the course of disease,UPDRS III score,Hoehn-Yahr grade and HAMD score were the influencing factors of serum 25-hydroxyvitamin D levels in PDD patients(all P<0.05).Serum 25-hydroxyvitamin D levels were negatively correlated with course of disease,UPDRS III and HAMD scores,and the correlation coefficients were-0.697,-0.546 and-0.640,respectively.The clinical efficacy of 25-hydroxyvitamin D levels in the diagnosis of depression in PD patients was significant.The AUC was 0.917.When the cut-off value was 18.38 ng/mL,the sensitivity and specificity were 94.91%and 90.23%,respectively.Conclusions The serum 25-hydroxyvitamin D levels in patients with PD combined with depression is significantly decreased.The occurrence of depression in patients with PD may be related to lower serum 25-hydroxyvitamin D levels and 25-hydroxyvitamin D levels may be as a biomarkers in the diagnose of depression in patients with PD.

关 键 词：帕金森病 抑郁症 25-羟基维生素D 相关性 ROC曲线 

分 类 号：R742.5[医药卫生—神经病学与精神病学]