摘要
目的 本研究探讨了甲状腺激素、性激素和皮质醇水平在不同严重程度的首发女性抑郁障碍患者中的分布差异,旨在深化对抑郁障碍激素调节机制的理解,并为临床诊断提供潜在的生物标志物.方法 选取2022年6月-2023年6月于开滦精神卫生中心住院的首发女性抑郁障碍患者150例.收集患者的一般资料,并测量甲状腺素[T4、T3、促甲状腺激素(TSH)、FT3、FT4]和性激素[睾酮(T)、催乳素(PRL)、孕酮(P)、雌二醇(E2)]水平,以及促肾上腺皮质激素(ACTH)和皮质醇(COR)水平.采用Zung氏抑郁自评量表(SDS)评估患者抑郁程度.根据SDS评分和临床医生的诊断,将患者分为轻中度抑郁组(70例)和重度抑郁组(80例).使用logistic回归及ROC曲线进行数据分析.结果 轻中度抑郁组患者的FT3、FT4水平高于重度抑郁组患者,而TSH、睾酮(T)、雌二醇(E2)、ACTH、COR水平则显著低于重度抑郁组(P＜0.05).低水平FT3和高水平T被认为是首发女性抑郁障碍患者重度发作的潜在危险因素.FT3和T水平用于诊断首发女性抑郁障碍患者为重度发作的曲线下面积分别为 0.687(95％CI:0.602～0.773,P＜0.001)和 0.654(95％CI:0.563～0.744,P=0.001).FT3 为 3.165 pg/mL时,诊断为重度发作的灵敏度为82.5％,特异度为51.4％;T为0.221 ng/mL时,灵敏度为75.0％,特异度为62.9％.结论 FT3和T水平的变化与首发女性抑郁障碍的严重程度有显著相关性,为抑郁障碍的生物标志物研究提供了新的视角.
Abstract
Objective This study aims to investigate the distribution differences of thyroid hormones,sex hormones,and cortisol levels in first-episode female patients with depression across varying severity levels.The goal was to deepen the understanding of the hormonal regulation mechanisms in depression and identify potential biomarkers for clinical diagno-sis.Methods A total of 150 first-episode female patients with depression hospitalized at the Kailuan Mental Health Cen-ter from June 2022 to June 2023 were selected.General information of the patients was collected,and the levels of thy-roid hormones(T4,T3,TSH,FT3,FT4),sex hormones(T,PRL,P,E2),adrenocorticotropic hormone(ACTH),and cortisol(COR)were measured.The severity of depression was assessed using the Zung self-rating depression scale(SDS).Based on the SDS scores and clinical diagnosis,patients were divided into a mild-to-moderate depression group(70 patients)and a severe depression group(80 patients).Logistic regression and ROC curve analysis were employed for data analysis.Results Patients in the mild-to-moderate depression group exhibited higher levels of FT3 and FT4,while lower levels of TSH,testosterone(T),estradiol(E2),ACTH,and COR compared to the severe depression group(P＜0.05).Low levels of FT3 and high levels of T were identified as potential risk factors for severe episodes in first-epi-sode female patients with depression.The area under the curve(AUC)for diagnosing severe episodes in first-episode fe-male patients with depression based on FT3 and T levels were 0.687(95％CI:0.602-0.773,P＜0.001)and 0.654(95％CI:0.563-0.744,P=0.001),respectively.At an FT3 level of 3.165 pg/mL,the sensitivity for diagnosing se-vere episodes was 82.5％with a specificity of 51.4％.Similarly,at a T level of 0.221 ng/mL,the sensitivity was 75.0％with a specificity of 62.9％.Conclusion Variations in FT3 and T levels are significantly correlated with the se-verity of first-episode depression in female patients,providing a new perspective on the study of biomarkers in depressive disorders.
基金项目
河北省医学科学研究课题(2023)(20231851)
维普
万方数据