首发围绝经期抑郁症病人血清雌激素水平 动态变化及其与认知功能的相关性.

苏晓云; 贺继平; 张晓宇; 张丽娜; 杨芯雨

Objective: To investigate the dynamic changes of serum oestrogen levels in patients with first⁃episode perimenopausal depression (PMD) and their correlation with cognitive function. Methods: 127 patients with first⁃episode PMD who visited Shanxi Fenyang Hospital from December 2021 to December 2022 were selected to be included in the PMD group, and 200 perimenopausal women who underwent a physical examination at our hospital during the same period were selected to be included in the control group. General information was collected and levels of sex hormones (oestrone (E1), oestradiol (E2), serum prolactin (PRL)), follicle⁃stimulating hormone (FSH), and luteinising hormone (LH), and norepinephrine (NE), dopamine (DA), brain⁃derived neurotrophic factor (BDNF), and 5⁃hydroxytryptophan (5 ⁃ HT) were measured in both groups at the time of visit; sex hormone and neurotransmitter levels were measured at different time points (at the time of consultation, 3 months, 6 months and 12 months after consultation) and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA) in the PMD group; sex hormone and neurotransmitter levels were analysed in relation to cognitive function using pearson's correlation; and risk factors affecting PMD were analysed using either unifactorial or multifactorial logistic regression equations; patients were divided into a cognitively impaired group (n=94) and a cognitively normal group (n=33) based on their MoCA scores at 12 months after the consultation, and clinical data and serological indices were compared between the two groups; the risk factors analysed using multifactorial logistic regression modelling. Results: The levels of E1, E2, NE, DA, BDNF, and 5⁃HT in the PMD group were significantly lower than those in the control group (P<0. 05); and the levels of PRL, FSH, and LH in the women in the PMD group were significantly higher than those in the control group (P<0. 05). With the increase of time, the levels of E1, E2, NE, DA, BDNF, and 5⁃HT in PMD patients showed a trend of gradual decrease, and there was a significant difference in the comparison between time points (P<0. 05); with the increase of time, the levels of PRL, FSH, and LH in patients in the PMD group showed a trend of gradual increase, and there was a significant difference in the comparison between time points (P<0. 05). After gradual exclusion of confounders with covariance, there was still an independent correlation between hormone indicators and the risk of cognitive impairment in patients with PMD (all P<0. 001). Conclusion: Different levels of sex hormones and neurotransmitter factors all affect the occurrence of PMD, and there is a certain correlation between the level of cognitive functioning and sex hormones and neurotransmitter factors of perimenopausal women. Sex hormone dynamic level monitoring can be carried out on perimenopausal women in order to intervene in PMD at an earlier stage.

PERIMENOPAUSE; SEX hormones; PEARSON correlation (Statistics); STATISTICAL significance; MULTIPLE regression analysis; ESTROGEN; MULTIVARIATE analysis; DESCRIPTIVE statistics; ESTRADIOL; PROLACTIN; FOLLICLE-stimulating hormone; LUTEINIZING hormone; NORADRENALINE; BRAIN-derived neurotrophic factor; STATISTICS; NEUROPSYCHOLOGICAL tests; DOPAMINE; TRYPTOPHAN; DATA analysis software; MENTAL depression; COGNITION; NEUROTRANSMITTERS; BLOOD

Chinese Nursing Research, 2024, Vol 38, Issue 13, p2302

1009-6493

Academic Journal

10.12102/j.issn.1009-6493.2024.13.008