上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

中重度抑郁症患者血清维生素D2/D3水平分析

胡瑶 1，毛旭东 2，刘晓华 1，陈海莹 1，曲毅 2，方贻儒 1，施慎逊 1，吴彦 1   

  1. 1. 上海交通大学 医学院附属精神卫生中心，上海 200030；2.上海市徐汇区中心医院，上海 200031
  • 出版日期:2017-03-28 发布日期:2017-03-30
  • 作者简介:胡瑶(1979—)，女，主治医师，学士；电子信箱：saveheart@163.com。
  • 基金资助:

    上海市卫生和计划生育委员会科研项目（20114303）；上海市自然科学基金（15ZR1435400）

Analyses of vitamin D2/D3 levels in moderately and severely depressive patients

HU Yao1, MAO Xu-dong2, LIU Xiao-hua1, CHEN Hai-ying1, QU Yi 2, FANG Yi-ru1, SHI1 Shen-xun1, WU Yan1   

  1. 1. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. Shanghai Xuhui Central District Hospital, Shanghai 200031, China
  • Online:2017-03-28 Published:2017-03-30
  • Supported by:

    Project of Shanghai Municipal Health and Family Planning Commission, 20114303; Natural Science Foundation of Shanghai, 15ZR1435400

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摘要：

目的 ·分析中重度抑郁症患者血清维生素D2/D3的水平。方法 ·选取符合抑郁症诊断标准的85例患者为病例组（中度抑郁者53例，重度抑郁者32例），同时选取50例年龄相仿的正常人作为对照组；采用液相色谱-质谱联用分析方法（LC-MS/MS）检测研究对象血清中的25（OH）D2、25（OH）D3及总浓度，并进行组间比较。采用Logistic回归筛选影响抑郁症患者抑郁严重程度的危险因素。结果 ·病例组维生素D2、D3以及总维生素D浓度均显著低于对照组（P=0.012，P=0.000，P=0.000）；重度组的维生素D2、D3以及总维生素D浓度低于对照组（均P=0.000）和中度组（P=0.007，P=0.010，P=0.002）。中度组仅维生素D3、总维生素D浓度与对照组的差异具有统计学意义（均P=0.000）。重度组的体质量指数显著高于对照组和中度组（均P=0.002）；超重/肥胖和总维生素D浓度是抑郁症严重程度的影响因素（P=0.034，P=0.011）。结论 ·不同严重程度的抑郁症患者均存在血清维生素D2、D3及总浓度的降低，而重度抑郁症患者的维生素D缺乏更严重，超重/肥胖更明显；为抑郁症患者制定治疗计划时，可能需考虑补充足量的维生素D和控制体质量。

关键词: 液相色谱-质谱联用, 25（OH）D2/D3, 体质量指数, 抑郁症, 严重程度

Abstract:

Objective · To detect the vitamin D2 and D3 levels in the patients with moderate and severe depression. Methods · Eighty-five patients who met the criteria for major depressive disorder were recruited (53 patients with moderate depression, 32 patients with severe depression). Fifty age-matched healthy volunteers were recruited as controls. Serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels were detected by using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The risk factors which might influence the severity of depression were screened by Logistic regression analysis. Results · The serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in the case group was lower than those in the control group (P=0.012, P=0.000, P=0.000). The patients with moderate depression presented significantly lower serum 25 (OH) D3 and total 25 (OH) D2/D3 levels than the controls did (P=0.000), although no significant difference in serum 25 (OH) D2 levels was found between these two groups. As well, the serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in patients with severe depression were significantly lower than those in patients with moderate depression and controls (P<0.05). The body mass index of severe depression group was much higher than that of moderate depression group and control group (P=0.002). Both overweight/obesity and the concentration of vitamin D may be the major influencing factors of depression severity (P=0.034, P=0.011). Conclusion · Vitamin D2 and D3 deficiency in depressive patients, particularly in those patients with severe depression, was shown in the present study. In addition, overweight/obesity as well as the concentration of vitamin D may exert the significant influence on the severity of depression. Vitamin D supplementation and weight control may be needed to be considered in making therapeutic strategies of major depressive disorder.

Key words: liquid chromatography-tandem mass spectrometry, 25(OH) D2/D3, body mass index, depression, severity