目的:抑郁症与低度全身炎症和肠功能受损有关,两者都可能减少饮食中铁的吸收。低铁状态与成人和青少年的抑郁症有关。在瑞士青少年中,我们确定了儿科重度抑郁症(pMDD)之间的关联,炎症,肠通透性和铁状态。
方法:这是一项匹配的病例对照研究,在95名诊断为pMDD的青少年和95名13-17岁的健康对照中进行。我们使用修订的儿童抑郁量表评估抑郁严重程度。我们测量了铁状态(血清铁蛋白(SF)和可溶性转铁蛋白受体(sTfR)),炎症(C反应蛋白(CRP)和α-1-酸性糖蛋白(AGP)),和肠通透性(肠脂肪酸结合蛋白(I-FABP))。我们通过自我报告问卷评估了ID诊断和治疗的历史。
结果:患有pMDD的青少年SF浓度(中位数(IQR)SF:31.2(20.2,57.0)μg/L)和对照组(32.5(22.6,48.3)μg/L,p=0.4)。sTfR低于对照组(4.50(4.00,5.50)mg/Lvs5.20(4.75,6.10)mg/L,p<0.001)。CRP,病例中AGP和I-FABP高于对照组(CRP:0.16(0.03,0.43)mg/Lvs0.04(0.02,0.30)mg/L,p=0.003;AGP:0.57(0.44,0.70)g/Lvs0.52(0.41,0.67)g/L,p=0.024);I-FABP:307(17,515)pg/mLvs232(163,357)pg/mL,p=0.047)。在案件中,44%的人报告有ID诊断史,而对照组为26%(p=0.020)。最后,28%的病例在/接近研究纳入时接受铁治疗,而对照组为14%。
结论:病例的全身炎症和肠通透性明显高于对照组,但铁状态没有降低。这是否与青少年抑郁症患者ID诊断和铁治疗的较高率有关尚不确定。
OBJECTIVE: Depression is associated with low-grade systemic inflammation and impaired intestinal function, both of which may reduce dietary iron absorption. Low iron status has been associated with depression in adults and adolescents. In Swiss adolescents, we determined the associations between paediatric major depressive disorder (pMDD), inflammation, intestinal permeability and iron status.
METHODS: This is a matched
case-control study in 95 adolescents with diagnosed pMDD and 95 healthy controls aged 13-17 years. We assessed depression severity using the Children\'s Depression Rating Scale-Revised. We measured iron status (serum ferritin (SF) and soluble transferrin receptor (sTfR)), inflammation (C-reactive protein (CRP) and alpha-1-acid-glycoprotein (AGP)), and intestinal permeability (intestinal fatty acid binding protein (I-FABP)). We assessed history of ID diagnosis and treatment with a self-reported questionnaire.
RESULTS: SF concentrations did not differ between adolescents with pMDD (median (IQR) SF: 31.2 (20.2, 57.0) μg/L) and controls (32.5 (22.6, 48.3) μg/L, p = 0.4). sTfR was lower among cases than controls (4.50 (4.00, 5.50) mg/L vs 5.20 (4.75, 6.10) mg/L, p < 0.001). CRP, AGP and I-FABP were higher among cases than controls (CRP: 0.16 (0.03, 0.43) mg/L vs 0.04 (0.02, 0.30) mg/L, p = 0.003; AGP: 0.57 (0.44, 0.70) g/L vs 0.52 (0.41, 0.67) g/L, p = 0.024); I-FABP: 307 (17, 515) pg/mL vs 232 (163, 357) pg/mL, p = 0.047). Of cases, 44% reported having a history of ID diagnosis compared to 26% among controls (p = 0.020). Finally, 28% of cases had iron treatment at/close to study inclusion compared to 14% among controls.
CONCLUSIONS: Cases had significantly higher systemic inflammation and intestinal permeability than controls but did not have lower iron status. Whether this is related to the higher rate of ID diagnosis and iron treatment in adolescents with depression is uncertain.