Characteristics of Somatic Symptoms and Their Correlations with Brain-derived Neurotrophic Factor and Inflammatory Cytokinesin Patients with Major Depressive Disorder

doi:10.12114/j.issn.1007-9572.2022.0652

Chinese General Practice ›› 2023, Vol. 26 ›› Issue (12): 1463-1471.DOI: 10.12114/j.issn.1007-9572.2022.0652

Special Issue: 精神卫生最新文章合集

• Original Research • Previous Articles Next Articles

Characteristics of Somatic Symptoms and Their Correlations with Brain-derived Neurotrophic Factor and Inflammatory Cytokinesin Patients with Major Depressive Disorder

¹Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, China
²Department of Psychiatry, Children's Hospital of Shanxi/Women Health Center of Shanxi, Taiyuan 030001, China
³School of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, China
The first author, DU Yeming, currently works at Songjiang District Mental Health Center, Shanghai

Received:2022-10-09 Revised:2022-12-11 Published:2023-04-20 Online:2022-12-30
Contact: WANG Yanfang

重性抑郁障碍患者躯体症状与脑源性神经营养因子和炎性因子的相关性研究

¹030001　山西省太原市，山西医科大学第一医院精神卫生科
²030001　山西省太原市，山西省儿童医院　山西省妇幼保健院精神卫生科
³030001　山西省太原市，山西医科大学基础医学院
第一作者都业铭现工作单位是：上海市松江区精神卫生中心

通讯作者: 王彦芳
作者简介:
作者贡献：都业铭、王彦芳进行文章的构思与设计、研究的实施与可行性分析、文章的质量控制及审校和论文修订；都业铭、张云巧、王宗琦、闵雪、崔雅莲进行数据收集和数据整理；都业铭负责统计学处理、结果分析与解释、撰写论文；王彦芳对文章整体负责，监督管理。
基金资助:
山西省卫健委科研基金项目(2022140); 山西省136兴医工程项目(Y2022136012); 山西省自然科学基金资助项目(201801D121345); 国家重点研发计划(2016YFC1307103)

Abstract

Abstract:

Background

Considerable evidence suggests that people with depressive disorder are at higher risk for somatic symptoms than normal people, but the mechanisms of susceptibility are unclear. Some studies suggest that the levels of precursor of brain-derived neurotrophic factor (ProBDNF) and inflammatory cytokines in depressive disorder patients are higher, but it is still unclear whether this is related to the accompanying somatic symptoms.

Objective

To explore the characteristics of somatic symptoms, and their correlations with BDNF and inflammatory cytokines in patients with major depressive disorder (MDD) .

Methods

A total of 59 MDD outpatients and inpatients from Mental Health Department, First Hospital of Shanxi Medical University and 32 healthy volunteers from the community were recruited from February 2019 to December 2020. Somatic symptoms were diagnosed using the Somatic Self-rating Scale (SSS, SSS score >36 and SSS score ≤36 were defined as with somatic symptoms or without, respectively) . Depression was assessed using the Hamilton Depression Rating Scale (HAMD-17) . Clinical data were collected, including gender, age, years of education, HAMD-17 score, SSS score, absorbance of ProBDNF and BDNF, and inflammatory cytokines (CRP, IL-4, IL-10, IL-18, IL-23a, HMGB1, IL-6, TNF-α, IFN-α) . Spearman's rank correlation analysis was used to investigate the correlation of somatic symptoms (including dizziness and headache, frequent and urgency of urination, cardiovascular symptoms, muscle soreness, gastrointestinal symptoms, tingling and twitching of hands and feet, choking and sighing, blurred vision, and discomfort of the throat) , SSS-S factor score and HAMD-17 score with ProBDNF and BDNF, and inflammatory cytokines.

Results

MDD patients with somatic symptoms had higher total HAMD-17 score than those without (P<0.001) . Both MDD patients with and without somatic symptoms had higher total HAMD-17 score than healthy volunteers (P<0.001) . MDD patients with somatic symptoms had higher total SSS score and SSS-S factor score than those without (P<0.001) . And they also had higher total SSS score and SSS-S factor score than healthy volunteers (P<0.001) . MDD patients with somatic symptoms had higher BDNF than those without (P<0.05) . The IFN-α in healthy volunteers was lower than of MDD patients with or without somatic symptoms (P<0.001) . ProBDNF was negatively correlated with muscle soreness (r_s=-0.262, P<0.05) . CRP was negatively correlated with tingling and twitching of hands and feet (r_s=-0.386, P<0.01) . IL-4 had a negative correlation with gastrointestinal symptoms (r_s=-0.336, P<0.01) . IL-10 had a positivecorrelation with blurred vision (r_s=0.286, P<0.05) . BDNF was positively correlated with dizziness and headache (r=0.339, P<0.01) , cardiovascular symptoms (r_s=0.309, P<0.05) , gastrointestinal symptoms (r_s=0.278, P<0.05) , muscle soreness (r_s=0.419, P<0.01) , tingling and twitching of hands and feet (r_s=0.286, P<0.05) , choking and sighing (r_s=0.372, P<0.01) , discomfort of the throat (r_s=0.392, P<0.01) and SSS-S factor score (r_s=0.418, P<0.01) . IL-6 was positively correlated with cardiovascular symptoms (r_s=0.283, P<0.05) and choking and sighing (r_s=0.374, P<0.01) . TNF-α was negatively correlated with muscle soreness (r_s=-0.299, P<0.05) . IFN-α showed a negative correlation with blurred vision (r_s=-0.267, P<0.05) .

Conclusion

The peripheral blood IFN-α of MDD patients was lower than that of normal people. The severity of depression and BDNF level were higher in MDD patients with somatic symptoms than those without. The elevation of multiple inflammatory cytokines was correlated with the increase in the risk of somatic symptoms, suggesting that patients with MDD may be prone to somatic symptoms and adverse outcomes, requiring early intervention.

Key words: Depression, Major depressive disorder, Inflammatory factor, Brain-derived neurotrophic factor, Somatic symptoms

摘要：

背景

大量证据表明抑郁障碍患者的躯体症状的风险比正常人高，但躯体易感性的机制尚不明确。部分研究认为前者脑源性神经营养因子前体（ProBDNF）、炎性因子水平比正常人高，而这是否与伴随的躯体症状有关还没有明确的结论。

目的

探讨重性抑郁障碍（MDD）患者躯体症状与脑源性神经营养因子（BDNF）、炎性因子的特征及其相关性。

方法

选取2019年2月至2020年12月山西医科大学第一医院精神卫生科门诊或住院部MDD患者59例与同期社区招募的健康志愿者32例作为研究对象。根据躯体化症状自评量表（SSS）将MDD患者分为伴躯体症状抑郁障碍（SD）组37例（SSS总分>36分）和不伴躯体症状抑郁障碍（NSD）组22例（SSS总分≤36分），32例健康志愿者为健康对照组（HC组）。收集临床资料，包括性别、年龄、受教育年限、17项汉密尔顿抑郁量表（HAMD-17）评分、SSS评分、BDNF、ProBDNF与炎性因子〔C反应蛋白（CRP）、白介素4（IL-4）、白介素6（IL-6）、白介素10（IL-10）、白介素18（IL-18）、白介素23a（IL-23a）、高迁移率族蛋白B1（HMGB1）、肿瘤坏死因子α（TNF-α）、α干扰素（IFN-α）〕的吸光度。采用SSS评估躯体化症状、HAMD-17评估抑郁障碍症状。采用Spearman秩相关分析探讨SSS中躯体症状（包括头晕头痛、尿频尿急、心血管症状、肌肉酸痛、胃肠道症状、手脚发麻抽搐、憋闷叹气、视物模糊、咽部不适）得分、躯体化症状自评量表-躯体化因子（SSS-S）总分、HAMD-17总分与BDNF、炎性因子的相关性。

结果

SD组HAMD-17总分高于NSD组、HC组（P<0.001）；NSD组HAMD-17总分高于HC组（P<0.001）。SD组SSS总分、SSS-S总分高于NSD组、HC组（P<0.001）。SD组BDNF高于NSD组（P<0.05）。SD组、NSD组的IFN-α低于HC组（P<0.001）。ProBDNF与肌肉酸痛呈负相关（r_s=-0.262，P<0.05），CRP与手脚发麻抽搐呈负相关（r_s=-0.386，P<0.01），IL-4与胃肠道症状呈负相关（r_s=-0.336，P<0.01），IL-10与视物模糊（r_s=0.286，P<0.05）呈正相关，BDNF与头晕头痛（r_s=0.339，P<0.01）、心血管症状（r_s=0.309，P<0.05）、胃肠道症状（r_s=0.278，P<0.05）、肌肉酸痛（r_s=0.419，P<0.01）、手脚发麻抽搐（r_s=0.286，P<0.05）、憋闷叹气（r_s=0.372，P<0.01）、咽部不适（r_s=0.392，P<0.01）、SSS-S总分（r_s=0.418，P<0.01）呈正相关。IL-6与心血管症状（r_s=0.283，P<0.05）、憋闷叹气（r_s=0.374，P<0.01）呈正相关。TNF-α与肌肉酸痛（r_s=-0.299，P<0.05）呈负相关。IFN-α与视物模糊（r_s=-0.267，P<0.05）呈负相关。

结论

MDD患者外周血IFN-α较正常人低，SD患者抑郁严重程度比NSD患者高，SD患者BDNF比NSD患者高，多种炎性因子水平与躯体症状呈正相关，或许提示抑郁患者可出现躯体症状及不良转归，需尽早干预。

关键词: 抑郁, 重性抑郁障碍, 炎性因子, 脑源性神经营养因子, 躯体症状

DU Yeming,ZHANG Yunqiao,WANG Zongqi, et al. Characteristics of Somatic Symptoms and Their Correlations with Brain-derived Neurotrophic Factor and Inflammatory Cytokinesin Patients with Major Depressive Disorder[J]. Chinese General Practice, 2023, 26(12): 1463-1471. DOI: 10.12114/j.issn.1007-9572.2022.0652.
都业铭,张云巧,王宗琦等. 重性抑郁障碍患者躯体症状与脑源性神经营养因子和炎性因子的相关性研究[J]. 中国全科医学, 2023, 26(12): 1463-1471. DOI: 10.12114/j.issn.1007-9572.2022.0652.

Figures/Tables 3

References 62

[1]	MALHI G S，MANN J J. Depression[J]. Lancet，2018，392（10161）：2299-2312. DOI：10.1016/S0140-6736(18)31948-2.
[2]	GENG J T，YAN R，SHI J B，et al. Altered regional homogeneity in patients with somatic depression：a resting-state fMRI study[J]. J Affect Disord，2019，246：498-505. DOI：10.1016/j.jad.2018.12.066.
[3]	SLYEPCHENKO A，MAES M，JACKA F N，et al. Gut microbiota，bacterial translocation，and interactions with diet：pathophysiological links between major depressive disorder and non-communicable medical comorbidities[J]. Psychother Psychosom，2017，86（1）：31-46. DOI：10.1159/000448957.
[4]	LIU P H，TU H W，ZHANG A X，et al. Brain functional alterations in MDD patients with somatic symptoms：a resting-state fMRI study[J]. J Affect Disord，2021，295：788-796. DOI：10.1016/j.jad.2021.08.143.
[5]	FANG X Y，ZHANG C，WU Z G，et al. The association between somatic symptoms and suicidal ideation in Chinese first-episode major depressive disorder[J]. J Affect Disord，2019，245：17-21. DOI：10.1016/j.jad.2018.10.110.
[6]	BEKHUIS E，BOSCHLOO L，ROSMALEN J G，et al. The impact of somatic symptoms on the course of major depressive disorder[J]. J Affect Disord，2016，205：112-118. DOI：10.1016/j.jad.2016.06.030.
[7]	PRIMO DE CARVALHO ALVES L，SICA DA ROCHA N. Lower levels of brain-derived neurotrophic factor are associated with melancholic psychomotor retardation among depressed inpatients[J]. Bipolar Disord，2018，20（8）：746-752. DOI：10.1111/bdi.12636.
[8]	UHER R，PAYNE J L，PAVLOVA B，et al. Major depressive disorder in DSM-5：implications for clinical practice and research of changes from DSM-Ⅳ[J]. Depress Anxiety，2014，31（6）：459-471. DOI：10.1002/da.22217.
[9]	李土明，毛家亮，钟萍，等. 以头晕为主诉的无症状脑梗死患者躯体化障碍的临床分析[J]. 卒中与神经疾病，2018，25（2）：159-162.
[10]	HIERONYMUS F，LISINSKI A，NILSSON S，et al. Influence of baseline severity on the effects of SSRIs in depression：an item-based，patient-level post-hoc analysis[J]. Lancet Psychiatry，2019，6（9）：745-752. DOI：10.1016/S2215-0366(19)30216-0.
[11]	张云巧，都业铭，崔雅莲，等. 重性抑郁障碍患者睡眠与躯体症状特征及其相关性研究[J]. 中国神经精神疾病杂志，2021，47（11）：661-665.
[12]	MILLER A H，MALETIC V，RAISON C L. Inflammation and its discontents：the role of cytokines in the pathophysiology of major depression[J]. Biol Psychiatry，2009，65（9）：732-741. DOI：10.1016/j.biopsych.2008.11.029.
[13]	SCHNIEDER T P，ZHOU QIN I D，TRENCEVSKA-IVANOVSKA I，et al. Blood vessels and perivascular phagocytes of prefrontal white and gray matter in suicide[J]. J Neuropathol Exp Neurol，2019，78（1）：15-30. DOI：10.1093/jnen/nly103.
[14]	SCHNIEDER T P，TRENCEVSKA I，ROSOKLIJA G，et al. Microglia of prefrontal white matter in suicide[J]. J Neuropathol Exp Neurol，2014，73（9）：880-890. DOI：10.1097/NEN.0000000000000107.
[15]	WOELFER M，KASTIES V，KAHLFUSS S，et al. The role of depressive subtypes within the neuroinflammation hypothesis of major depressive disorder[J]. Neuroscience，2019，403：93-110. DOI：10.1016/j.neuroscience.2018.03.034.
[16]	KITZBICHLER M G，ARULDASS A R，BARKER G J，et al. Peripheral inflammation is associated with micro-structural and functional connectivity changes in depression-related brain networks[J]. Mol Psychiatry，2021，26（12）：7346-7354. DOI：10.1038/s41380-021-01272-1.
[17]	KAPPELMANN N，LEWIS G，DANTZER R，et al. Antidepressant activity of anti-cytokine treatment：a systematic review and meta-analysis of clinical trials of chronic inflammatory conditions[J]. Mol Psychiatry，2018，23（2）：335-343. DOI：10.1038/mp.2016.167.
[18]	CALCIA M A，BONSALL D R，BLOOMFIELD P S，et al. Stress and neuroinflammation：a systematic review of the effects of stress on microglia and the implications for mental illness[J]. Psychopharmacology （Berl），2016，233（9）：1637-1650. DOI：10.1007/s00213-016-4218-9.
[19]	VAN EEDEN W A，VAN HEMERT A M，CARLIER I V E，et al. Severity，course trajectory，and within-person variability of individual symptoms in patients with major depressive disorder[J]. Acta Psychiatr Scand，2019，139（2）：194-205. DOI：10.1111/acps.12987.
[20]	BEYDOUN M A，OBHI H K，WEISS J，et al. Systemic inflammation is associated with depressive symptoms differentially by sex and race：a longitudinal study of urban adults[J]. Mol Psychiatry，2020，25（6）：1286-1300. DOI：10.1038/s41380-019-0408-2.
[21]	JACOB L，ROCKEL T，KOSTEV K. Depression risk in patients with rheumatoid arthritis in the united kingdom[J]. Rheumatol Ther，2017，4（1）：195-200. DOI：10.1007/s40744-017-0058-2.
[22]	KANG H，SCHUMAN E. Long-lasting neurotrophin-induced enhancement of synaptic transmission in the adult Hippocampus[J]. Science，1995，267（5204）：1658-1662. DOI：10.1126/science.7886457.
[23]	LUO L，LI C Q，DU X X，et al. Effect of aerobic exercise on BDNF/proBDNF expression in the ischemic Hippocampus and depression recovery of rats after stroke[J]. Behav Brain Res，2019，362：323-331. DOI：10.1016/j.bbr.2018.11.037.
[24]	LIN L Y，HERSELMAN M F，ZHOU X F，et al. Effects of corticosterone on BDNF expression and mood behaviours in mice[J]. Physiol Behav，2022，247：113721. DOI：10.1016/j.physbeh.2022.113721.
[25]	CUBEDDU A，BUCCI F，GIANNINI A，et al. Brain-derived neurotrophic factor plasma variation during the different phases of the menstrual cycle in women with premenstrual syndrome[J]. Psychoneuroendocrinology，2011，36（4）：523-530. DOI：10.1016/j.psyneuen.2010.08.006.
[26]	ORAL E，OZCAN H，KIRKAN T S，et al. Luteal serum BDNF and HSP70 levels in women with premenstrual dysphoric disorder[J]. Eur Arch Psychiatry Clin Neurosci，2013，263（8）：685-693. DOI：10.1007/s00406-013-0398-z.
[27]	FELGER J C，HAROON E，PATEL T A，et al. What does plasma CRP tell us about peripheral and central inflammation in depression? [J]. Mol Psychiatry，2020，25（6）：1301-1311. DOI：10.1038/s41380-018-0096-3.
[28]	FELGER J C，LI Z，HAROON E，et al. Inflammation is associated with decreased functional connectivity within corticostriatal reward circuitry in depression[J]. Mol Psychiatry，2016，21（10）：1358-1365. DOI：10.1038/mp.2015.168.
[29]	IOB E，KIRSCHBAUM C，STEPTOE A. Persistent depressive symptoms，HPA-axis hyperactivity，and inflammation：the role of cognitive-affective and somatic symptoms[J]. Mol Psychiatry，2020，25（5）：1130-1140. DOI：10.1038/s41380-019-0501-6.
[30]	孙宁，张克让. 抑郁症发病炎性机制的研究进展[J]. 中华精神科杂志，2016，49（4）：251-254. DOI：10.3760/cma.j.issn.1006-7884.2016.04.011.
[31]	PITHAROULI M C，HAGENAARS S P，GLANVILLE K P，et al. Elevated C-reactive protein in patients with depression，independent of genetic，health，and psychosocial factors：results from the UK biobank[J]. Am J Psychiatry，2021，178（6）：522-529. DOI：10.1176/appi.ajp.2020.20060947.
[32]	HAAPAKOSKI R，MATHIEU J，EBMEIER K P，et al. Cumulative meta-analysis of interleukins 6 and 1β，tumour necrosis factor α and C-reactive protein in patients with major depressive disorder[J]. Brain Behav Immun，2015，49：206-215. DOI：10.1016/j.bbi.2015.06.001.
[33]	LAAKE J P S，STAHL D，AMIEL S A，et al. The association between depressive symptoms and systemic inflammation in people with type 2 diabetes：findings from the South London Diabetes Study[J]. Diabetes Care，2014，37（8）：2186-2192. DOI：10.2337/dc13-2522.
[34]	LAMERS F，MILANESCHI Y，SMIT J H，et al. Longitudinal association between depression and inflammatory markers：results from the Netherlands study of depression and anxiety[J]. Biol Psychiatry，2019，85（10）：829-837. DOI：10.1016/j.biopsych.2018.12.020.
[35]	ENGLER H，BRENDT P，WISCHERMANN J，et al. Selective increase of cerebrospinal fluid IL-6 during experimental systemic inflammation in humans：association with depressive symptoms[J]. Mol Psychiatry，2017，22（10）：1448-1454. DOI：10.1038/mp.2016.264.
[36]	DEL GIUDICE M，GANGESTAD S W. Rethinking IL-6 and CRP：why they are more than inflammatory biomarkers，and why it matters[J]. Brain Behav Immun，2018，70：61-75. DOI：10.1016/j.bbi.2018.02.013.
[37]	KÖHLER C A，FREITAS T H，MAES M，et al. Peripheral cytokine and chemokine alterations in depression：a meta-analysis of 82 studies[J]. Acta Psychiatr Scand，2017，135（5）：373-387. DOI：10.1111/acps.12698.
[38]	HE Y，GAO Y，ZHANG Q，et al. IL-4 switches microglia/macrophage M1/M2 polarization and alleviates neurological damage by modulating the JAK1/STAT6 pathway following ICH[J]. Neuroscience，2020，437：161-171. DOI：10.1016/j.neuroscience.2020.03.008.
[39]	LIU J J，WEI Y B，STRAWBRIDGE R，et al. Peripheral cytokine levels and response to antidepressant treatment in depression：a systematic review and meta-analysis[J]. Mol Psychiatry，2020，25（2）：339-350. DOI：10.1038/s41380-019-0474-5.
[40]	TANG J，YU W B，CHEN S，et al. Microglia polarization and endoplasmic Reticulum stress in chronic social defeat stress induced depression mouse[J]. Neurochem Res，2018，43（5）：985-994. DOI：10.1007/s11064-018-2504-0.
[41]	CHAN C C，BUGGAGE R R，NUSSENBLATT R B. Intraocular lymphoma[J]. Curr Opin Ophthalmol，2002，13（6）：411-418. DOI：10.1097/00055735-200212000-00012.
[42]	LASSELIN J，ELSENBRUCH S，LEKANDER M，et al. Mood disturbance during experimental endotoxemia：Predictors of state anxiety as a psychological component of sickness behavior[J]. Brain Behav Immun，2016，57：30-37. DOI：10.1016/j.bbi.2016.01.003.
[43]	HODES G E，MÉNARD C，RUSSO S J. Integrating Interleukin-6 into depression diagnosis and treatment[J]. Neurobiol Stress，2016，4：15-22. DOI：10.1016/j.ynstr.2016.03.003.
[44]	RIDKER P M，EVERETT B M，THUREN T，et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease[J]. N Engl J Med，2017，377（12）：1119-1131. DOI：10.1056/NEJMoa1707914.
[45]	MARTÍNEZ-HERVÁS S，GONZÁLEZ-NAVARRO H. Anti-inflammatory therapies for cardiovascular disease：signaling pathways and mechanisms[J]. Rev Esp Cardiol （Engl Ed），2019，72（9）：767-773. DOI：10.1016/j.rec.2019.03.007.
[46]	SWANSON K V，DENG M，TING J P Y. The NLRP3 inflammasome：molecular activation and regulation to therapeutics[J]. Nat Rev Immunol，2019，19（8）：477-489. DOI：10.1038/s41577-019-0165-0.
[47]	WONG M L，INSERRA A，LEWIS M D，et al. Inflammasome signaling affects anxiety- and depressive-like behavior and gut microbiome composition[J]. Mol Psychiatry，2016，21（6）：797-805. DOI：10.1038/mp.2016.46.
[48]	PROSSIN A R，KOCH A E，CAMPBELL P L，et al. Acute experimental changes in mood state regulate immune function in relation to central opioid neurotransmission：a model of human CNS-peripheral inflammatory interaction[J]. Mol Psychiatry，2016，21（2）：243-251. DOI：10.1038/mp.2015.110.
[49]	WESTERTERP M，FOTAKIS P，OUIMET M，et al. Cholesterol efflux pathways suppress inflammasome activation，NETosis，and atherogenesis[J]. Circulation，2018，138（9）：898-912. DOI：10.1161/CIRCULATIONAHA.117.032636.
[50]	SONG A Q，GAO B，FAN J J，et al. NLRP1 inflammasome contributes to chronic stress-induced depressive-like behaviors in mice[J]. J Neuroinflammation，2020，17（1）：178. DOI：10.1186/s12974-020-01848-8.
[51]	WITTENBERG G M，STYLIANOU A，ZHANG Y，et al. Effects of immunomodulatory drugs on depressive symptoms：a mega-analysis of randomized，placebo-controlled clinical trials in inflammatory disorders[J]. Mol Psychiatry，2020，25（6）：1275-1285. DOI：10.1038/s41380-019-0471-8.
[52]	GAIECKA M，BLIZNIEWSKA-KOWALSKA K，ORZECHOWSKA A，et al. Inflammatory versus anti-inflammatory profiles in major depressive disorders-the role of IL-17，IL-21，IL-23，IL-35 and Foxp3[J]. J Pers Med，2021，11（2）：66. DOI：10.3390/jpm11020066.
[53]	GUO J N，LIU Y，GUO X Y，et al. Depressive-like behaviors in mice with imiquimod-induced psoriasis[J]. Int Immunopharmacol，2020，89（Pt B）：107057. DOI：10.1016/j.intimp.2020.107057.
[54]	ABRAHAM E，ANZUETO A，GUTIERREZ G，et al. Double-blind randomised controlled trial of monoclonal antibody to human tumour necrosis factor in treatment of septic shock. NORASEPT ⅡStudy Group[J]. Lancet，1998，351（9107）：929-933.
[55]	MS S A B，WALDMAN PHD H S，KRINGS PHD B M，et al. Effect of curcumin supplementation on exercise-induced oxidative stress，inflammation，muscle damage，and muscle soreness[J]. J Diet Suppl，2020，17（4）：401-414. DOI：10.1080/19390211.2019.1604604.
[56]	RONG L B，PERELSON A S. Treatment of hepatitis C virus infection with interferon and small molecule direct antivirals：viral kinetics and modeling[J]. Crit Rev Immunol，2010，30（2）：131-148. DOI：10.1615/critrevimmunol.v30.i2.30.
[57]	TREUSCH M，VONTHEIN R，BAUR M，et al. Influence of human recombinant interferon-alpha2a （rhIFN-alpha2a） on altered lymphocyte subpopulations and monocytes in Behcet's disease[J]. Rheumatology （Oxford），2004，43（10）：1275-1282. DOI：10.1093/rheumatology/keh311.
[58]	LIU X L，DIEDRICHS-MÖHRING M，WILDNER G. The role of IFN-alpha in experimental and clinical uveitis[J]. Ocul Immunol Inflamm，2019，27（1）：23-33. DOI：10.1080/09273948.2017.1298822.
[59]	FRANKLIN T C，WOHLEB E S，ZHANG Y，et al. Persistent increase in microglial RAGE contributes to chronic stress-induced priming of depressive-like behavior[J]. Biol Psychiatry，2018，83（1）：50-60. DOI：10.1016/j.biopsych.2017.06.034.
[60]	YAN W X，XIE L P，BI Y M，et al. Combined rs-fMRI study on brain functional imaging and mechanism of RAGE-DAMPs of depression：evidence from MDD patients to chronic stress-induced depression models in cynomolgus monkeys and mice[J]. Clin Transl Med，2021，11（10）：e541. DOI：10.1002/ctm²541.
[61]	XU X，LU Y N，CHENG J H，et al. Ginsenoside Rh2 reduces depression in offspring of mice with maternal Toxoplasma infection during pregnancy by inhibiting microglial activation via the HMGB1/TLR4/NF-κB signaling pathway[J]. J Ginseng Res，2022，46（1）：62-70. DOI：10.1016/j.jgr.2021.04.003.
[62]	XIE J F，BI B T，QIN Y Y，et al. Inhibition of phosphodiesterase-4 suppresses HMGB1/RAGE signaling pathway and NLRP3 inflammasome activation in mice exposed to chronic unpredictable mild stress[J]. Brain Behav Immun，2021，92：67-77. DOI：10.1016/j.bbi.2020.11.029.

组别	例数	性别〔n（%）〕		年龄〔M（P₂₅，P₇₅），岁〕	受教育年限〔M（P₂₅，P₇₅），年〕	HAMD-17总分〔M（P₂₅，P₇₅），分〕	SSS总分〔M（P₂₅，P₇₅），分〕	SSS-S总分〔M（P₂₅，P₇₅），分〕
组别	例数	男	女	年龄〔M（P₂₅，P₇₅），岁〕	受教育年限〔M（P₂₅，P₇₅），年〕	HAMD-17总分〔M（P₂₅，P₇₅），分〕	SSS总分〔M（P₂₅，P₇₅），分〕	SSS-S总分〔M（P₂₅，P₇₅），分〕
SD组	37	10（27.0）	27（73.0）	27（22，39）	14（11，15）	21（19，24）	50（42，58）	18（16，23）
NSD组	22	10（45.5）	12（54.5）	33（22，49）	15（15，15）	17（17，18）^a	33（28，34）^a	12（10，13）^a
HC组	32	16（50.0）	16（50.0）	31（26，33）	15（14，15）	1（1，3）^ab	24（21，28）^a	10（9，12）^a
H（χ²）值		4.029^c		3.340	8.210	70.931	60.536	44.615
P值		0.122		0.188	0.017	<0.001	<0.001	<0.001

组别	例数	性别〔n（%）〕		年龄〔M（P₂₅，P₇₅），岁〕	受教育年限〔M（P₂₅，P₇₅），年〕	HAMD-17总分〔M（P₂₅，P₇₅），分〕	SSS总分〔M（P₂₅，P₇₅），分〕	SSS-S总分〔M（P₂₅，P₇₅），分〕
组别	例数	男	女	年龄〔M（P₂₅，P₇₅），岁〕	受教育年限〔M（P₂₅，P₇₅），年〕	HAMD-17总分〔M（P₂₅，P₇₅），分〕	SSS总分〔M（P₂₅，P₇₅），分〕	SSS-S总分〔M（P₂₅，P₇₅），分〕
SD组	37	10（27.0）	27（73.0）	27（22，39）	14（11，15）	21（19，24）	50（42，58）	18（16，23）
NSD组	22	10（45.5）	12（54.5）	33（22，49）	15（15，15）	17（17，18）^a	33（28，34）^a	12（10，13）^a
HC组	32	16（50.0）	16（50.0）	31（26，33）	15（14，15）	1（1，3）^ab	24（21，28）^a	10（9，12）^a
H（χ²）值		4.029^c		3.340	8.210	70.931	60.536	44.615
P值		0.122		0.188	0.017	<0.001	<0.001	<0.001

组别	例数	BDNF	ProBDNF	CRP	IL-4	IL-6
SD组	37	0.422（0.328，0.534）	0.187（0.180，0.217）	0.238（0.213，0.257）	0.089（0.077，0.094）	0.054（0.051，0.059）
NSD组	22	0.301（0.275，0.449）^a	0.207（0.098，0.212）	0.242（0.070，0.268）	0.083（0.080，0.093）	0.053（0.051，0.061）
HC组	32	0.341（0.276，0.422）	0.184（0.074，0.215）	0.216（0.153，0.242）	0.088（0.080，0.097）	0.056（0.052，0.074）
H值		8.110	1.955	4.216	0.353	1.823
P值		0.017	0.376	0.121	0.838	0.402
组别	IL-10	IL-18	IL-23a	HMGB1	TNF-α	IFN-α
SD组	0.082（0.079，0.085）	0.106（0.098，0.127）	0.033（0.030，0.035）	0.231（0.190，0.287）	0.082（0.079，0.083）	0.128（0.124，0.135）
NSD组	0.080（0.079，0.083）	0.099（0.095，0.119）	0.035（0.030，0.035）	0.214（0.198，0.262）	0.082（0.080，0.084）	0.134（0.125，0.139）
HC组	0.081（0.079，0.084）	0.107（0.095，0.117）	0.033（0.031，0.036）	0.246（0.204，0.273）	0.081（0.079，0.082）	0.142（0.137，0.145）^ab
H值	1.519	1.245	0.726	2.608	3.816	31.708
P值	0.468	0.537	0.696	0.271	0.148	<0.001

组别	例数	BDNF	ProBDNF	CRP	IL-4	IL-6
SD组	37	0.422（0.328，0.534）	0.187（0.180，0.217）	0.238（0.213，0.257）	0.089（0.077，0.094）	0.054（0.051，0.059）
NSD组	22	0.301（0.275，0.449）^a	0.207（0.098，0.212）	0.242（0.070，0.268）	0.083（0.080，0.093）	0.053（0.051，0.061）
HC组	32	0.341（0.276，0.422）	0.184（0.074，0.215）	0.216（0.153，0.242）	0.088（0.080，0.097）	0.056（0.052，0.074）
H值		8.110	1.955	4.216	0.353	1.823
P值		0.017	0.376	0.121	0.838	0.402
组别	IL-10	IL-18	IL-23a	HMGB1	TNF-α	IFN-α
SD组	0.082（0.079，0.085）	0.106（0.098，0.127）	0.033（0.030，0.035）	0.231（0.190，0.287）	0.082（0.079，0.083）	0.128（0.124，0.135）
NSD组	0.080（0.079，0.083）	0.099（0.095，0.119）	0.035（0.030，0.035）	0.214（0.198，0.262）	0.082（0.080，0.084）	0.134（0.125，0.139）
HC组	0.081（0.079，0.084）	0.107（0.095，0.117）	0.033（0.031，0.036）	0.246（0.204，0.273）	0.081（0.079，0.082）	0.142（0.137，0.145）^ab
H值	1.519	1.245	0.726	2.608	3.816	31.708
P值	0.468	0.537	0.696	0.271	0.148	<0.001

项目	BDNF	ProBDNF	CRP	IL-4	IL-10	IL-18	IL-23a	HMGB1	IL-6	TNF-α	IFN-α
HAMD-17总分	0.020	0.096	0.229	-0.073	0.008	-0.007	-0.117	0.253	-0.024	-0.192	-0.075
头晕头痛	0.339^a	-0.157	0.059	0.015	0.135	0.121	-0.183	0.040	0.106	-0.115	-0.176
心血管症状	0.309^a	-0.245	-0.092	0.168	0.208	0.072	0.009	0.115	0.283^b	-0.042	-0.212
胃肠道症状	0.278^a	-0.068	-0.119	-0.336^a	-0.092	0.056	0.166	0.176	-0.013	-0.201	-0.238
肌肉酸痛	0.419^a	-0.262^a	-0.207	0.141	0.197	0.247	-0.117	0.044	0.052	-0.299^a	-0.159
手脚发麻抽搐	0.286^a	-0.125	-0.386^a	-0.181	-0.027	0.018	-0.159	-0.065	-0.001	-0.025	-0.147
视物模糊	0.186	-0.141	-0.061	0.083	0.286^a	-0.096	-0.209	0.093	0.028	-0.215	-0.267^b
憋闷叹气	0.372^a	-0.020	-0.142	-0.008	0.014	0.161	-0.113	-0.024	0.374^a	-0.035	-0.232
咽部不适	0.392^a	-0.138	-0.066	-0.156	-0.154	0.196	-0.107	-0.017	-0.151	-0.029	-0.062
尿频尿急	-0.172	-0.190	-0.182	0.047	0.083	-0.196	-0.058	0.003	0.131	-0.191	0.006
SSS-S总分	0.418^a	-0.150	-0.181	-0.059	0.054	0.123	-0.119	0.037	0.162	-0.164	-0.243

Characteristics of Somatic Symptoms and Their Correlations with Brain-derived Neurotrophic Factor and Inflammatory Cytokinesin Patients with Major Depressive Disorder

重性抑郁障碍患者躯体症状与脑源性神经营养因子和炎性因子的相关性研究

RichHTML

PDF

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 3

References 62

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	LIU Xinyi, LIU Zhandong. Research Progress of Anxiety and Depression Related to Chronic Fatigue Syndrome [J]. Chinese General Practice, 2023, 26(35): 4477-4482.
[2]	WANG Yue, CHEN Qing, LIU Lurong. Detection Rate of Depression and Its Influencing Factors in Chinese Elderly: a Meta-analysis [J]. Chinese General Practice, 2023, 26(34): 4329-4335.
[3]	YANG Lu, ZONG Zhanhong, YI Yingying. Current Status and Influencing Factors of Depression among Rural Middle-aged and Elderly Women in China [J]. Chinese General Practice, 2023, 26(25): 3091-3095.
[4]	YIN Cong, DIAO He, SHENG Wei, CAO Yan, BAI Wenpei. Influence of Daily Self-weighing Supported by Online Supervision on Body Composition and Emotions in Overweight/Obese Women with Anxiety and Depression [J]. Chinese General Practice, 2023, 26(24): 2992-2996.
[5]	WANG Minghuan, LI Yuhong, YUAN Dehui, YU Min, HAN Baoliang, YU Qiaozhi, YANG Fangfang, ZHANG Qin. Correlation between Allostatic Load Level and Depression among Women in Early Pregnancy [J]. Chinese General Practice, 2023, 26(21): 2609-2613.
[6]	MENG Huilin, GUO Fei, CHEN Zhiyan. Influence of Parent-grandparent Coparenting Conflict on Grandparents' Depression Mediated by Grandparents' Sense of Mastery and Moderated by Their Sense of Valued Elder [J]. Chinese General Practice, 2023, 26(16): 2004-2012.
[7]	YUAN Dehui, LI Yuhong, DONG Yuanyuan, WANG Minghuan. Relationship between Different Personality Traits and Postpartum Depression: a Meta-analysis [J]. Chinese General Practice, 2023, 26(14): 1775-1782.
[8]	JIANG Yue, LI Jie. General Practitioner Implements Family Therapy for a Depressed Patient [J]. Chinese General Practice, 2023, 26(13): 1667-1670.
[9]	SUN Liang, LIU Zhiwei, ZHANG Yulong, ZHANG Dapeng, LI Wenzheng, YAO Xianhu, LIU Huanzhong. Plasma Cytokine Level and Influencing Factors of Depression in Stable Schizophrenia Patients [J]. Chinese General Practice, 2023, 26(06): 687-691.
[10]	WANG Kekai, YANG Yanlin, ZHOU Yanni, XIAO Jin, XIE Xin, WU Qinping, CHEN Min. Efficacies of Tong-Xie-Yao-Fang Disassembled Recipes on Brain-gut Peptideina Rat Model of Diarrhea-predominant Irritable Bowel Syndrome [J]. Chinese General Practice, 2023, 26(05): 569-575.
[11]	DU Yeming, ZHANG Yunqiao, HAN Min, WANG Yanfang. A Comparative Study of Event-related Potential N400 between Anxious and Melancholic Depression [J]. Chinese General Practice, 2022, 25(36): 4546-4553.
[12]	CHEN Pinqi, ZHANG Liqing, XIANG Ting, SUN Xizhe, PAN Jiyang. Advances in the Use of Regional Homogeneity from Resting-state Functional MRI for the Diagnosis of Insomnia in Depressive Disorder [J]. Chinese General Practice, 2022, 25(35): 4462-4467.
[13]	PAN Jiyang, FANG Yiru, HU Shaohua, LU Zheng, SU Changjun, TANG Xiangdong, WANG Tao, WANG Wenqiang, YAO Zhijian, YUAN Yonggui, YU Huan, ZHAN Shuqin, ZHAO Zhongxin, ZHANG Xulai, ZHANG Ling, LI Lingjiang. Expert Recommendations for Clinical Application of Trazodone Hydrochloride Sustained Release [J]. Chinese General Practice, 2022, 25(33): 4099-4105.
[14]	LIU Xianling, HONG Jian, WANG Kai, QIAN Lijun, SUN Yan, MA Wenjie, LI Zhongming, XU Di. Progress in Clinical Treatment of Heart Failure with Preserved Ejection Fraction Combined with Depression [J]. Chinese General Practice, 2022, 25(33): 4196-4202.
[15]	WANG Nan, Motuziuk OLEKSANDR, Mishchenko IRYNA, ZHOU Yingting. Levels of Relevant Inflammatory Factors and Oxidative Stress Markers in Alcoholic Myopathy: a Meta-analysis [J]. Chinese General Practice, 2022, 25(33): 4123-4129.