Potential Biomarkers for Diagnosing Major Depressive Disorder Patients with Suicidal Ideation.
Potential Biomarkers for Diagnosing Major Depressive Disorder Patients with Suicidal Ideation.
复制标题
用于诊断有自杀意念的重度抑郁症患者的潜在生物标志物
DOI：
10.2147/jir.s297930
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发表时间：
2021
影响因子：
4.5
通讯作者：
Chen JJ
中科院分区：
文献类型：
--
作者：
Bai S;Fang L;Xie J;Bai H;Wang W;Chen JJ
重度抑郁障碍（MDD）和自杀是两种主要的健康问题，但目前仍没有客观的方法来诊断MDD或自杀意念（SI）。本研究旨在确定诊断重度抑郁症合并SI患者的潜在生物标志物。方法招募首发drug-naïve伴有SI的MDD患者和人口统计学匹配的健康对照（hc）。首发drug-naïve无SI的MDD患者也包括在内。检测血脂、c反应蛋白（CRP）、转运蛋白（TRSF）、同型半胱氨酸（HCY）、α - 1抗胰蛋白酶（AAT）。使用单变量和多变量统计分析来识别和验证潜在的生物标志物。结果本组共纳入hcc 86例，伴有SI的MDD患者53例，无SI的MDD患者20例。确定了四种潜在的生物标志物：AAT、TRSF、高密度脂蛋白胆固醇（HDLC）和载脂蛋白A1 （APOA1）。治疗1个月后，AAT和APOA1水平均有明显改善。由这些潜在生物标志物组成的小组具有出色的诊断性能，在训练集和测试集的ROC曲线下面积（AUC）分别为0.994和0.990。此外，该小组可以有效区分有SI的MDD患者和没有SI的MDD患者（AUC=0.928）。结论这些潜在的生物标志物有助于建立一种客观的诊断MDD患者SI的方法，MDD患者AAT水平的降低可能通过引起炎症升高而导致SI的出现。
Background Major depressive disorder (MDD) and suicide are two major health problems, but there are still no objective methods to diagnose MDD or suicidal ideation (SI). This study was conducted to identify potential biomarkers for diagnosing MDD patients with SI. Methods First-episode drug-naïve MDD patients with SI and demographics-matched healthy controls (HCs) were recruited. First-episode drug-naïve MDD patients without SI were also included. The serum lipids, C-reactive protein (CRP), transferring (TRSF), homocysteine (HCY) and alpha 1-antitrypsin (AAT) in serum were detected. The univariate and multivariate statistical analyses were used to identify and validate the potential biomarkers. Results The 86 HCs, 53 MDD patients with SI and 20 MDD patients without SI were included in this study. Four potential biomarkers were identified: AAT, TRSF, high-density lipoprotein cholesterol (HDLC), and apolipoprotein A1 (APOA1). After one month treatment, the levels of AAT and APOA1 were significantly improved. The panel consisting of these potential biomarkers had an excellent diagnostic performance, yielding an area under the ROC curve (AUC) of 0.994 and 0.990 in the training and testing set, respectively. Moreover, this panel could effectively distinguish MDD patients with SI from MDD patients without SI (AUC=0.928). Conclusion These results showed that these potential biomarkers could facilitate the development of an objective method for diagnosing MDD patients with SI, and the decreased AAT levels in MDD patients might lead to the appearance of SI by resulting in the elevated inflammation.