血清BDNF及RBP4与代谢综合征共病抑郁症患者抑郁程度的关系研究

李思情; 梁冰; 田沛冉; 金国玺; 蒋淑红

doi:10.16766/j.cnki.issn.1674-4152.004161

血清BDNF及RBP4与代谢综合征共病抑郁症患者抑郁程度的关系研究

doi: 10.16766/j.cnki.issn.1674-4152.004161

1.
蚌埠医科大学第一附属医院全科医学科，安徽蚌埠 233004
2.
蚌埠医科大学第一附属医院内分泌科
3.
安徽省荣军医院蚌埠门诊部，安徽蚌埠 233000

基金项目:

安徽省重点研究与开发计划项目 202204295107020049

蚌埠医学院2023年度研究生科研创新计划项目 Byycx23148

详细信息

通讯作者:
梁冰，E-mail：407281726@qq.com

中图分类号: R58 R749.25
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出版历程
- 收稿日期: 2024-10-08
- 网络出版日期: 2025-11-17

Correlation between serum BDNF and RBP4 levels and depressive severity in patients with co-morbid depression and metabolic syndrome

1.
Department of General Practice, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

摘要

摘要: 目的探究血清脑源性神经营养因子(BDNF)和视黄醇结合蛋白4(RBP4)与代谢综合征(MS)共病抑郁症(MDD)患者抑郁程度的关系及诊断价值, 以期为MS共病MDD的预防与诊治提供新的理论依据。方法选取2023年10月—2024年7月蚌埠医科大学第一附属医院收治的166例MS患者，根据有无共病MDD分为MS共病MDD组(观察组，114例)和MS组(对照组，52例)；选取70例同期本院体检健康者设为健康组；将MS共病MDD组患者根据抑郁程度分为轻度组(53例)、中度组(39例)和重度组(22例)3个亚组。分析MS共病MDD患者血清BDNF、RBP4水平与汉密尔顿抑郁量表(HAMD)评分的相关性以及两者对MS共病MDD的诊断价值。结果对照组及健康组血清BDNF、RBP4水平均低于观察组，差异有统计学意义(P < 0.05)。MS共病MDD患者3个亚组间比较，轻度抑郁组和中度抑郁组血清BDNF、RBP4水平高于重度抑郁组，差异均有统计学意义(P < 0.05)。回归分析显示，血清BDNF、RBP4均为MS共病MDD的影响因素(P < 0.05)。ROC曲线显示，血清BDNF、RBP4诊断MS共病MDD的截断值分别为254.80 pg/mL、37.50 mg/L, 灵敏度分别为85.96%、61.40%, 特异度均为78.85%，曲线下面积分别为0.863、0.736，二者联合诊断的灵敏度为77.19%，特异度为84.62%，曲线下面积为0.887。结论血清BDNF和RBP4对MS共病MDD有较好的预测价值。
- 代谢综合征 /
- 抑郁症 /
- 脑源性神经营养因子 /
- 视黄醇结合蛋白4 /
- 抑郁程度
Abstract: Objective To investigate the relationship between serum levels of brain-derived neurotrophic factor (BDNF) and retinol binding protein 4 (RBP4) and the degree of depression in patients with metabolic syndrome (MS) co-morbid with major depressive disorder (MDD), as well as its diagnostic value. In order to provide a new theoretical basis for the prevention, diagnosis and treatment of MS comorbidities with MDD. Methods A total of 166 MS patients admitted to the First Affiliated Hospital of Bengbu Medical University from October 2023 to July 2024 were selected and divided into MS co-morbid MDD group (observation group, 114 cases) and MS group (control group, 52 cases) according to the presence or absence of co-morbid depressive disorder; 70 healthy people who had medical checkups in our hospital during the same period were selected and set up as the healthy group. In the MS co-morbid MDD group, they were divided into three subgroups according to the degree of depression: mild (n=53), moderate (n=39) and severe (n=22). The correlation between the serum BDNF and RBP4 levels and the HAMD score of MS patients with co-morbid MDD, and the diagnostic value of the two for MS co-morbid MDD were analyzed. Results The serum BDNF and RBP4 levels in the control and healthy groups were lower than those in the observation group, and the difference was statistical significance (P < 0.05). Comparison among the three subgroups: serum BDNF and RBP4 levels were higher in the mildly depressed and moderately depressed groups than those in the severely depressed group, and the difference was statistical significance (P < 0.05). Regression analysis showed that BDNF and RBP4 were protective factors for MS co-morbid of MDD (P < 0.05). ROC curves showed that the cut-off values of serum BDNF and RBP4 in patients of the observation group were 254.80 pg/mL and 37.50 mg/L, respectively, with a sensitivity of 85.96% and 61.40%, a specificity of 78.85%, and an area under the curve of 0.863 and 0.736, and the sensitivity of the combination of the two was 77.19%, the specificity was 84.62%, and the area under the curve was 0.887. Conclusion Detection of serum BDNF and RBP4 is valuable in diagnosing MDD in MS.
- Metabolic syndrome /
- Depression /
- Brain-derived neurotrophic factor /
- Retinol-binding protein 4 /
- Degree of depression

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图 1 血清BDNF和RBP4单独及联合诊断MS共病MDD的ROC曲线

Figure 1. ROC curve of serum BDNF and RBP4 alone and combined in the diagnosis of MDD in MS comorbidities

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表 1 3组研究对象一般资料及生化指标比较

Table 1. Comparison of general information and biochemical indexes of the three groups

项目	健康组(n=70)	对照组(n=52)	观察组(n=114)	统计量	P值
性别(男/女, 例)	33/37	28/24	59/55	0.609^c	0.737
年龄(x±s, 岁)	52.07±11.18	54.85±13.06	53.08±14.33	0.665^d	0.515
BMI[M(P₂₅, P₇₅)]	23.44(20.91, 25.76)	25.56(24.22, 27.60)^a	25.59(23.86, 27.25)^a	30.011^e	<0.001
WC[M(P₂₅, P₇₅), cm]	80.00(76.00, 83.00)	90.50(87.00, 94.00)^a	87.00(80.00, 91.00)^ab	60.990^e	<0.001
TC[M(P₂₅, P₇₅), mmol/L]	4.62(4.04, 5.26)	4.76(3.99, 5.72)	4.83(4.21, 5.79)	3.041^e	0.219
TG[M(P₂₅, P₇₅), mmol/L]	1.10(0.75, 1.40)	1.88(1.43, 2.53)^a	1.95(1.44, 2.99)^a	75.449^e	<0.001
HDL-C[M(P₂₅, P₇₅), mmol/L]	1.38(1.19, 1.56)	1.19(1.00, 1.46)^a	1.17(1.01, 1.35)^a	21.735^e	<0.001
LDL-C[M(P₂₅, P₇₅), mmol/L]	2.20(1.87, 2.76)	2.61(2.21, 3.18)^a	2.69(2.02, 3.20)	7.499^e	0.024
APO(a)[M(P₂₅, P₇₅), g/L]	1.32(1.18, 1.55)	1.11(0.96, 1.24)^a	1.09(0.95, 1.23)^a	43.323^e	<0.001
APO(b)[M(P₂₅, P₇₅), g/L]	0.80(0.70, 0.92)	0.93(0.79, 1.12)^a	0.87(0.75, 1.01)^a	13.686^e	<0.001
UA[M(P₂₅, P₇₅), μmol/L]	245.50(212.00, 290.75)	307.50(244.00, 366.50)^a	326(259.50, 380.25)^a	30.952^e	<0.001
FPG[M(P₂₅, P₇₅), mmol/L]	4.41(4.10, 4.72)	7.83(5.75, 9.55)^a	7.36(5.57, 10.48)^a	88.979^e	<0.001
SBP[M(P₂₅, P₇₅), mmHg]	126.00(112.75, 132.00)	139.50(128.25, 149.00)^a	141.00(130.00, 150.25)^a	49.909^e	<0.001
DBP[M(P₂₅, P₇₅), mmHg]	76.50(69.00, 82.00)	81.00(75.50, 87.75)^a	85.00(78.00, 91.00)^a	35.763^e	<0.001
CysC[M(P₂₅, P₇₅), mg/L]	0.80(0.76, 0.89)	0.93(0.84, 1.10)^a	0.96(0.81, 1.13)^a	30.023^e	<0.001
注：与健康组比较，^aP＜0.05；与对照组比较，^bP＜0.05。^c为χ²值，^d为F值，^e为H值。1 mmHg=0.133 kPa。

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表 2 3组研究对象血清BDNF及RBP4水平比较[M(P₂₅, P₇₅)]

Table 2. Comparison of serum BDNF and RBP4 among the three groups[M(P₂₅, P₇₅)]

组别	例数	BDNF(pg/mL)	RBP4(mg/L)
健康组	70	376.00(335.81, 426)	33.00(30.00, 38.00)
对照组	52	290.27(261.34, 425.93)^a	45.50(38.00, 48.75)^a
观察组	114	172.22(121.17, 233.43)^ab	35.00(30.00, 42.00)^b
H值		134.949	37.534
P值		＜0.001	＜0.001
注：与健康组比较，^aP＜0.05；与对照组比较，^bP＜0.05。

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表 3 不同抑郁严重程度MS共病MDD患者血清BDNF和RBP4水平比较[M(P₂₅, P₇₅)]

Table 3. Comparison of serum BDNF and RBP4 expression levels in different depression severity[M(P₂₅, P₇₅)]

组别	例数	BDNF(pg/mL)	RBP4(mg/L)
轻度组	53	229.00(187.61, 250.74)	37.00(32.00, 46.50)
中度组	39	136.50(128.41, 186.17)^a	36.00(32.00, 43.00)
重度组	22	70.75(52.68, 90.38)^ab	30.00(27.00, 32.25)^ab
H值		49.681	16.952
P值		<0.001	<0.001
注：与轻度组比较，^aP＜0.05；与中度组比较，^bP＜0.05。

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表 4 MS患者共病MDD影响因素的多因素logistic回归分析

Table 4. Multivariate logistic regression analysis of comorbid depressive disorder in MS patients

变量	B	SE	Waldχ²	P值	OR值	95% CI
BDNF	-0.018	0.003	31.567	＜0.001	0.983	0.977~0.989
RBP4	-0.075	0.022	11.983	＜0.001	0.928	0.889~0.968

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表 5 血清BDNF和RBP4单独及联合诊断MS共病MDD的效能分析

Table 5. The diagnostic efficacy analysis of serum BDNF and RBP4 alone and combination in diagnosing MS comorbid MDD

项目	最佳截断值	AUC	95% CI	P值	灵敏度(%)	特异度(%)	约登指数
BDNF	254.80 pg/mL	0.863	0.800~0.925	＜0.001	85.96	78.85	0.648
RBP4	37.50 mg/L	0.736	0.660~0.813	＜0.001	61.40	78.85	0.403
二者联合		0.887	0.833~0.941	＜0.001	77.19	84.62	0.618

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