抑郁症患者血清紧密连结蛋白-5和内源性配体-13水平变化及其与病情发展和睡眠障碍的关系

doi:10.3969/j.issn.1006-5725.2024.12.011

Abstract

Abstract:

Objective To investigate the changes in serum levels of claudin-5 and Apelin-13 in patients with depression and their relationship with disease progression and sleep disorders. Methods A total of 128 patients with depression admitted to our hospital from June 2021 to July 2023 were selected as the study group， and another 128 patients who underwent physical examinations during the same period were selected as the control group. The correlation between the expression levels of serum claudin-5 and Apelin-13 in patients with depression and the Hamilton Depression Rating Scale （HAMD） score， as well as the diagnostic value of serum claudin-5 and Apelin-13 for the severity of depression in patients were analyzed. Results The expression level of claudin-5 in the serum of patients in study group was higher than that of the control group， which increased with the severity of the disease （P < 0.05） and was positively correlated with the HAMD score （r = 0.713， P < 0.05）. In addition， the expression level of claudin-5 in the serum of patients with sleep disorders was higher than that of those without sleep disorders （P < 0.05）， and the trend of changes in the expression level of Apelin-13 was opposite； Age， age at onset of depression， and claudin-5 were factors for sleep disorders in patients with depression， while Apelin-13 was a protective factor （P < 0.05）； The combined detection of serum claudin-5 and Apelin-13 is superior to their individual detection（Z_{combined detection - claudin-5} = 2.393， Z_{combined detection - Apelin-13} = 1.964， P = 0.016， 0.044）. Conclusion The expression levels of claudin-5 and Apelin-13 in serum of patients with depression were related to the progression of disease and the sleep disorders and the combined detection has high diagnostic value for severe depression.

Key words: depression, claudin-5, apelin-13, sleep disorders

CLC Number:

R749

Figures/Tables 9

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References 26

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组别	例数	年龄（岁）	男性［例（%）］	BMI（kg/m²）	吸烟史［例（%）］
对照组	128	33.52 ± 5.72	60（46.87）	23.55 ± 3.49	42（32.81）
观察组	128	32.88 ± 5.05	51（39.84）	23.72 ± 3.12	38（29.68）
χ ² /t值		0.949	1.288	0.411	0.291
P值		0.344	0.256	0.682	0.590

组别	例数	claudin-5（ng/mL）	Apelin-13（ng/mL）	HAMD评分（分）
轻度组	58	61.22 ± 7.09	29.81 ± 3.71	11.73 ± 2.31
中度组	46	75.38 ± 7.83^a	24.55 ± 3.09^a	20.58 ± 2.92^a
重度组	24	84.11 ± 9.22^ab	20.03 ± 2.56^ab	27.55 ± 3.71^ab
F值		86.869	82.104	297.016
P值		< 0.001	< 0.001	< 0.001

组别	例数	claudin-5	Apelin-13
无睡眠障碍组	37	56.14 ± 6.53	32.11 ± 3.88
睡眠障碍组	91	76.61 ± 8.42	23.64 ± 2.91
t值		13.246	13.503
P值		< 0.001	< 0.001

组别	年龄（岁）		性别		婚姻状况
组别	＜35	≥35	男	女	有配偶	无配偶
无睡眠障碍组	27（35.53）	10（19.23）	17（33.33.）	20（25.97）	25（29.76）	12（27.27）
睡眠障碍组	49（64.47）	42（80.77）	34（66.67）	57（74.03）	59（70.24）	32（72.73）
χ ² 值	3.99		0.809		0.087
P值	0.046		0.369		0.768

指标	β	SE	Wald	P值	OR	95%CI
年龄	0.622	0.231	7.242	0.007	1.862	1.184 ~ 2.928
首发抑郁年龄	0.573	0.209	7.523	0.006	1.774	1.178 ~ 2.672
claudin-5	0.750	0.287	6.838	0.009	2.118	1.207 ~ 3.717
Apelin-13	-0.489	0.194	6.364	0.012	0.613	0.419 ~ 0.897

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变量	AUC	截断值（ng/mL）	95%CI	敏感度（%）	特异度（%）	Youden指数
claudin-5	0.857	78.35	0.785 ~ 0.913	66.67	96.15	0.628
Apelin-13	0.817	23.64	0.738 ~ 0.879	58.33	90.38	0.487
二者联合	0.909	-	0.845 ~ 0.953	87.50	85.58	0.730

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