成年人重性抑郁障碍与血脂及载脂蛋白的相关性分析  

Association between major depressive disorder with serum lipid and apolipoproteins in adults

作　　者：王璇[1] 王停停 王景华 赵津京 崔勇[1] 卞清涛[1] 乞盟 王宁[1] 李红娟[1] 胡颂箫 陈景旭[1] WANG Xuan;WANG Tingting;WANG Jinghua;ZHAO Jinjing;CUI Yong;BIAN Qingtao;QI Meng;WANG Ning;LIHongjuan;HU Songxiao;CHEN Jingxu(Huilongguan Clinical Medical School of Peking University,Beijing Huilongguan Hospital,Beijing 100096,China;Bengbu Medical College,Bengbu 233030,Anhui Province,China;The 305 Hospital of PLA,Beijing 100017,China;Chengde Medical College,Chengde 067050,Hebei Province,China;Pinggu Campus of Beijing Friendship Hospital,Capital Medical University,Beijing 101200,China)

机构地区：[1]北京大学回龙观临床医学院北京回龙观医院,北京100096 [2]蚌埠医学院,安徽蚌埠233030 [3]解放军第三〇五医院,北京100017 [4]承德医学院,河北承德067050 [5]首都医科大学附属北京友谊医院平谷医院,北京101200

出　　处：《解放军医学院学报》2022年第6期681-685,共5页Academic Journal of Chinese PLA Medical School

基　　金：北京市委组织部优秀人才项目(2015000021469G175)。

摘　　要：背景重性抑郁障碍(major depressive disorder,MDD)是一种病因和病理生理复杂的常见精神疾病,其分子机制尚未完全阐明,目前一些研究结果提示脂质代谢与MDD的发生、发展可能存在一定关系。目的探讨成年人MDD与血脂之间的相关性。方法回顾性分析2019年2月-2020年9月入住北京回龙观医院的138例MDD患者,另选健康对照86例,常规采静脉血通过酶法检测血脂等生化指标。结果与对照组比较,MDD组载脂蛋白Al(apolipoprotein A1,ApoA1)水平明显低于对照组[(1.39±0.34)g/L vs(1.71±0.31)g/L,P=0.000],高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDLC)水平高于对照组[(1.40±0.38)mmol/L vs(1.31±0.28)mmol/L,P=0.008]。单因素分析结果表明体质量指数(body mass index,BMI)、吸烟史、受教育年限和ApoA1水平均与MDD具有显著相关性(P均<0.05)。多元logistic回归分析显示中等水平[(1.47±0.09)g/L]和高水平[(1.92±0.27)g/L]ApoA1相比低水平[(1.14±0.11)g/L]ApoA1发生MDD的风险均降低0.99倍(OR=0.01,95%CI:0.00~0.07,P<0.0001);调整相关危险因素后结果没有明显改变,中等水平和高水平ApoA1仍然比低水平ApoA1发生MDD的风险分别降低0.94倍和0.89倍(OR=0.06,95%CI:0.01~0.42,P=0.0048;OR=0.11,95%CI:0.02~0.80,P=0.0288);HDL-C水平在MDD的发生风险中无统计学意义(P>0.05)。结论MDD患者血清ApoA1水平明显低于对照组,ApoA1有可能是MDD的独立危险因素,进一步的结论尚需更多的研究证实。Background Major depressive disorder(MDD)is a common mental disorder with complex etiology and pathophysiology.However,the molecular mechanism of MDD has not been fully elucidated.Currently,a few studies suggest that lipid metabolism may be related to the occurrence and development of MDD.Objective To explore the correlation of MDD with serum lipid and related proteins in adults.Methods From February 2019 to September 2020,138 patients with MDD admitted to Beijing Huilongguan Hospital and 86 healthy controls were included.Venous blood samples were collected to detect biochemical indexes such as blood lipids by enzymatic method.Results Compared with the control group,the patients with MDD had lower levels of ApoA1([1.39±0.34]g/L vs[1.71±0.31]g/L,P=0.000)and higher levels of HDL-C([1.40±0.38]mmol/L vs[1.31±0.28]mmol/L,P=0.008).Univariate analysis of depression-related factors showed that BMI,smoking history,education years and ApoA1 levels were significantly correlated with MDD(all P<0.05).Multiple logistic regression analysis showed that the risk of MDD at middle([1.47±0.09]g/L)and high levels([1.92±0.27]g/L)of ApoA1 was 0.99 times lower than that at low levels([1.14±0.11]g/L)of ApoA1(OR=0.01,95%CI:0.00-0.07,P<0.0001,respectively).After adjusting the related risk factors,there was no obvious change in the results.The risk of MDD in middle-level and high-level ApoA1 groups was still lower than that in low-level ApoA1 group by 0.94 times and 0.89 times,respectively(OR=0.06,95%CI:0.01-0.42,P=0.0048;OR=0.11,95%CI:0.02-0.80,P=0.0288).But the level of HDL-C had no significant difference in the risk of MDD(P<0.05).Conclusion The level of ApoA1 in patients with MDD is significantly lower than that in the control group.ApoA1 may be an independent risk factor for MDD,which still needs to be confirmed by more studies.

关 键 词：重性抑郁障碍 脂质代谢 血脂 载脂蛋白A1 成年人 

分 类 号：R749.4[医药卫生—神经病学与精神病学]