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Biol Psychiatry:抑郁症致c反应蛋白水平提高

2012/01/13 来源:生物谷
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导读
抑郁症会导致体内炎症反应。CRP水平最高的是那些曾经有过多次严重抑郁症发作的儿童。这也提示了有这么种可能性,儿童时期就开始的长时间情绪困扰,会引发炎症反应,从而在中年时期引发心血管疾病和糖尿病。

抑郁症的累积发作次数跟CRP升高相关,所以要格外重视儿童抑郁症。

精神病学领域的科学家们一直对机体的炎症反应跟抑郁症的是否有因果联系争论不休。近日,刊登在Biological Psychiatry杂志上的一项新的研究"Cumulative depression episodes predict later C-reactive protein levels: a prospective analysis"试图解开这个谜题。

在很多疾病中都可以看到机体的炎症反应,如高血压,冠心病,糖尿病。抑郁症则跟一种血液中的炎症标志物——C反应蛋白(CRP)有关。

杜克大学医学中心的William Copeland博士和他的同事为研究抑郁症和CRP之间是否直接关联,对由青少年和年轻人构成的志愿者进行了一项大样本测试。通过追踪儿童成长为年轻人,研究者们可以评估其随着时间的推移,CRP水平和抑郁症发作情况。

他们发现CRP水平升高不是抑郁症的预测因素,但是抑郁症的累积发作次数跟CRP升高相关。

Copeland说:“我们的研究结果支持即使考虑了其他一些会影响炎症反应与健康相关的行为因素,儿童患抑郁症仍会提高CRP水平。但我们没有发现CRP的升高会增加会抑郁症的风险。”

这些研究结果表明,抑郁症会导致体内炎症反应。CRP水平最高的是那些曾经有过多次严重抑郁症发作的儿童。这也提示了有这么种可能性,儿童时期就开始的长时间情绪困扰,会引发炎症反应,从而在中年时期引发心血管疾病和糖尿病。

Biological Psychiatry的编辑John Krystal博士认为:“对许多人来说,抑郁症是一个经常要面对的问题。因此这项研究结果的意义在于反复发作的抑郁需要得到重视,因为它会导致炎症,从而引发更多更严重的其他疾病。这些数据也为进一步加强对抑郁症的治疗和重视提供了支持。”。


Cumulative depression episodes predict later C-reactive protein levels: a prospective analysis.

Copeland WE, Shanahan L, Worthman C, Angold A, Costello EJ.

BACKGROUND Depression is associated with elevated levels of the inflammation marker C-reactive protein (CRP); yet, the direction of this association remains unclear. This study tested bi-directional longitudinal associations between CRP and depression in a sample of adolescents and young adults. The study compared the effect of current depression with the effect of cumulative episodes of depression over time.

METHODS Nine waves of data from the prospective population-based Great Smoky Mountains Study (n = 1420) were used, covering children in the community aged 9 to 16, 19, and 21 years old. Structured interviews were used to assess depressive symptoms, depression diagnosis, and cumulative depressive episodes. Bloodspots were collected at each observation and assayed for CRP levels.

RESULTS CRP levels were not associated with later depression status. In contrast, all depression-related variables displayed evidence of association with later CRP levels. The associations with depressive symptoms and diagnostic status were attenuated after controlling for covariates, particularly body mass index, smoking, and medication use. The effect of cumulative depressive episodes, however, continued to be significant after accounting for a range of covariates. Body mass index, smoking behavior, and recent infections may mediate a portion of the effect of cumulative episodes on later CRP, but cumulative depressive episodes continued to predict CRP levels independently.

CONCLUSIONS The occurrence of multiple depressive episodes exerted the greatest effect on later CRP levels. This suggests that risk for the diseases of middle and old age-cardiovascular and metabolic disease-may begin in childhood and depend, in part, on long-term emotional functioning.

文献链接:http://www.biologicalpsychiatryjournal.com/article/S0006-3223(11)00923-1/abstract

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