Cortisol rhythm disorder and influencing factors of patients with anxious depression

Abstract

Objective To explore the relationship between anxious depression and cortisol rhythm disorder and influencing factors of immune metabolism.And to look for biological markers that can be used for clinical diagnosis and treatment of anxious depression. Methods Totally 43 patients with anxious depression(A-MDD group) and 44 patients with non-anxious depression matched by sex, age and years of education(NA-MDD group)were recruited.Electrochemiluminescence was used to detect the plasma levels of adrenocorticotropic hormone(ACTH), cortisol(COR), c-reactive protein(CRP) and IL-6.Automatic biochemical analysis was used to detect plasma total TC, TG, HDL and LDL.Using logistic regression analysis to discuss the influencing factors of anxiety depression. Results The comparison between the two group showed that the age of first onset, BMI and SBP in the A-MDD group((35.15±11.56), (24.11±3.03)kg/m2, (130.09±13.33)mmHg) were significantly higher than those in the NA-MDD group((31.34±14.08), ( 22.70±3.19)kg/m2, ( 121.89±12.49)mmHg)(t=2.631, 2.009, 2.964, all P<0.05). The HAMD score and the factor scores of cognitive impairment, change of day and night, delay, sleep disorder and feeling of despair in the A-MDD group((31.81±5.39), (8.03±3.00), (1.17±0.70), (6.88±1.93), (4.44±1.44), (4.67±2.37)) were significantly higher than those in the NA-MDD group((25.25±5.017), (3.87±3.12), (0.79±0.78), (4.64±2.22), (3.34±1.54), (3.61±2.02))(t=2.297, 6.524, 2.505, 5.210, 3.452, 2.421, all P<0.05). The plasma TG, CRP and IL-6 levels in the A-MDD group((1.63±1.11)mmol/L, (1.20±0.77)mg/L, (3.54±1.90)pg/L) were significantly higher than those in the NA-MDD group ((1.19±0.66)mmol/L, (0.933±0.89)mg/L, (2.65±1.34)pg/L) (t=2.254, 2.250, 2.352, all P<0.05). The incidence of cortisol disturbance was 72% in the A-MDD group, and 48% in the NA-MDD group, and the difference was statistically significant (χ2=5.369 P=0.020). Multivariate Logistic regression found that sleep disorder (β=0.729, OR=2.072, 95%CI=1.018-3.119), IL-6(β=0.583, OR=1.792, 95%CI=1.168-2.748), cognitive impairment (β=0.099, OR=1.104, 95%CI=1.022-1.193), cortisol rhythm disorders(β=0.075, OR=1.078, 95%CI=1.014-1.146)were the risk factors for anxious depression. Conclusion Anxious depression has a high incidence of cortisol rhythm disorder.The COR and IL-6 may be mediators of cortisol rhythm disorder.IL-6 and cortisol rhythm disorder together with sleep disorder and negative cognition constitute maybe high risk factors for anxious depression. Key words: Anxious depression; Cortisol rhythm; IL-6; Sleep disorder