FGF21 Is Associated with Metabolic Effects and Treatment Response in Depressed Bipolar II Disorder Patients Treated with Valproate.
FGF21 Is Associated with Metabolic Effects and Treatment Response in Depressed Bipolar II Disorder Patients Treated with Valproate.
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DOI：
10.1093/ijnp/pyx093
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发表时间：
2018-04-01
期刊：
影响因子：
--
通讯作者：
Lu RB
中科院分区：
文献类型：
--
作者：
Chang HH;Chen PS;Cheng YW;Wang TY;Yang YK;Lu RB
双相情感障碍患者在接受情绪稳定剂治疗后，代谢紊乱的风险很高。然而，这两种情况之间的联系尚不清楚。在这项研究中，我们调查是否成纤维细胞生长因子-21（FGF 21）与代谢的影响和抑郁症双相情感障碍患者的治疗反应。我们招募了78名社区居民和137名双相情感障碍患者，后者使用中文版的情感障碍和精神分裂症-生活时间的修订表进行了访谈。在进入研究时，双相情感障碍患者都处于重度抑郁状态，17项汉密尔顿抑郁评定量表（HDRS）评分>15。他们接受丙戊酸盐（每日500-1000 mg）治疗12周，并允许每日20 mg氟西汀治疗抑郁症状。在基线和治疗12周后收集FGF 21的空腹血浆水平、脂质谱和体重。基线时，对照组和双相情感障碍患者的人口统计学特征、FGF 21水平和代谢指标无显著差异。治疗12周后，FGF 21水平（167.7±122.0至207.1±162.3 pg/mL，P= 0.001）、体重和腰围显著增加（分别为P<0.001和P= 0.028）。此外，FGF 21水平的变化与HDRS评分（r=0.393，P=.002）、总胆固醇（r=-0.344，P=.008）和低密度脂蛋白（r=-0.347，P=.007）的变化显著相关。FGF 21在双相障碍抑郁治疗中的中枢和外周介导作用可能相反。高外周FGF 21水平可能将双相情感障碍的代谢效应调节与治疗抵抗联系起来。
Patients with bipolar disorder are at high risk of metabolic disturbance after mood stabilizer treatment. However, the mediators linking the two conditions remain unknown. In this study, we investigated whether fibroblast growth factor-21 (FGF21) was associated with metabolic effects and treatment response in depressed bipolar disorder patients. We recruited 78 community-dwelling controls and 137 bipolar disorder patients; the latter were interviewed using the Chinese Version of the Modified Schedule of Affective Disorder and Schizophrenia–Life Time. Upon study entry, the bipolar disorder patients were all in a major depressive status, with 17-item Hamilton Depression Rating Scale (HDRS) scores >15. They received valproate (500–1000 mg daily) for 12 weeks, and fluoxetine 20 mg daily was permitted to treat depressive symptoms. Fasting plasma level of FGF21, lipid profiles, and body weight were collected at baseline and after 12 weeks of treatment. At baseline, the demographic characteristics, FGF21 level, and metabolic indices did not differ significantly between the controls and bipolar disorder patients. After 12 weeks of treatment, the FGF21 level (167.7±122.0 to 207.1±162.3 pg/mL, P=.001), body weight and waist circumference had increased significantly (P<.001 and P=.028, respectively). Moreover, the change in FGF21 level was significantly correlated with the changes in HDRS score (r=0.393, P=.002), total cholesterol (r=−0.344, P=.008), and low-density lipoprotein (r=−0.347, P=.007). The central and peripheral mediating effects of FGF21 on bipolar disorder depression treatment might be opposite. High peripheral FGF21 levels might link regulation of metabolic effect and resistance to treatment in bipolar disorder.
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