■维生素D缺乏与糖尿病周围神经病变(DPN)患者有关,低水平的维生素D在抑郁症患者中很常见。抑郁症在DPN患者中很常见,确切的发病机制尚不清楚。本研究旨在确定维生素D缺乏在DPN抑郁症发作和评估维生素D补充对抑郁症的影响。
■本研究共纳入192例DPN患者。收集临床和实验室信息。化学发光免疫测定用于测量25(OH)D的水平。采用酶联免疫吸附试验测定白细胞介素(IL)-1β的浓度,肿瘤坏死因子-α(TNF-α),IL-17A具有低25(OH)D的受试者每天接受5000IU维生素D,持续12周。抑郁评分和25(OH)D水平,IL-1β,TNF-α,补充后重新评估IL-17A。
■DPN患者维生素D缺乏和抑郁的发生率较高。与维生素D充足的参与者相比,汉密尔顿抑郁量表(HAMD)评分与炎症标志物IL-1β、TNF-α,不足组的IL-17A和IL-17A均显着升高(均p<0.05)。HAMD得分,IL-1β,TNF-α,IL-17A与25(OH)D呈负相关(p均<0.05)。IL-1β之间存在线性关系,TNF-α,IL-17A,和25(OH)D(p<0.05)。HAMD得分,IL-1β,TNF-α,补充维生素D后,IL-17A和IL-17A均显着降低(p<0.05)。二元Logistic分析显示维生素D不足是DPN患者抑郁的独立危险因素。受试者工作特征(ROC)曲线分析显示,25(OH)D在区分DPN抑郁症患者中具有很高的敏感性(87.20%)。
■维生素D缺乏参与了DPN患者抑郁症的发生,并可能被介导,至少在某种程度上,通过上调促炎细胞因子。补充维生素D可有效改善DPN患者的抑郁症状。
UNASSIGNED: Vitamin D deficiency is associated with patients with diabetic peripheral neuropathy (DPN), and low levels of vitamin D are common in patients with depression. Depression is common in DPN patients and the definite pathogenesis remains unclear. This study aimed to determine vitamin D deficiency in the onset of depression in DPN and evaluate the effect of vitamin D supplementation on depression.
UNASSIGNED: A total of 192 patients with DPN were enrolled in this study. Clinical and laboratory information was collected. Chemiluminescent immunoassay was used to measure the level of 25(OH)D. Enzyme-linked immunosorbent assay was employed to measure the concentrations of interleukin (IL)-1β, tumor necrosis factor-α (TNF-α), and IL-17A. Subjects with low 25(OH)D received 5000IU vitamin D daily for 12 weeks. Depression scores and levels of 25(OH)D, IL-1β, TNF-α, and IL-17A were re-evaluated after supplementation.
UNASSIGNED: The incidence of vitamin D deficiency and depression was high in DPN patients. Compared with vitamin D sufficient participants, Hamilton Depression Rating Scale (HAMD) scores and the levels of inflammatory markers IL-1β, TNF-α, and IL-17A were significantly higher in insufficient group (all p<0.05). HAMD score, IL-1β, TNF-α, and IL-17A were negatively correlated with 25(OH)D (all p<0.05). A linear relationship existed among IL-1β, TNF-α, IL-17A, and 25(OH)D (p<0.05). HAMD scores, IL-1β, TNF-α, and IL-17A were all reduced significantly after supplementation of vitamin D (p<0.05). Binary logistic analysis revealed that vitamin D insufficiency was an independent risk factor for depression in patients with DPN. Receiver operating characteristic (ROC) curve analysis showed a high sensitivity (87.20%) of 25(OH)D in discriminating DPN patients with depression.
UNASSIGNED: Vitamin D deficiency participated in occurrence of depression in DPN patients and could be mediated, at least in part, by upregulation of pro-inflammatory cytokines. Vitamin D supplementation may be effective in improving depressive symptoms in DPN patients.