| Objective: To examine the association between serotonin transporter polymorphic region (5-HTTLPR) and susceptibility to subcortical ischemic depression (SID) among the Chinese Han, so as to provide theoretic evidences for clarifying the etiology of SID.Methods: A case control study was carried out, with polymerase chain reaction-restriction fraction length polymorphism technique, 5-HTTLPR were determined in 36 patients with SID, 24 patients with subcortical ischemic vascular disease no depression (SIVD) and 60 control subjects. Multinomial Logistic regression model was conducted to examine the association between 5-HTTLPR and susceptibility to SID, SIVD, after adjusting for age, gender and education status.Results: Totally two alleles of 375bp (S) and 419bp (L) were observed,there genotype distribution found were SS, LS and LL.There were significant differences in the frequency of 5-HTTLPR genotypes between SID, SIVD and control group (χ~2=17.986,P=0.001). The frequency of 5-HRRLPR SS genotypes were significantly higher in SID group (69.4%) than SIVD group (29.2%) and control group (28.3%) (χ~2=17.430,P=0.0002). The frequency of 5-HRRLPR LS genotypes were significantly lower in SID group (16.7%) than SIVD group (50.0%) and control group (48.3%) (χ~2=10.947,P=0.004).There were significant differences in the frequency of 5-HTTLPR allele between SID, SIVD and control group (χ~2=13.003,P=0.002). The frequency of 5-HRRLPR S alleles was significantly higher in SID group (77.8%) than SIVD group (54.2%) and control group (52.5%). The frequency of 5-HRRLPR L alleles was significantly lower in SID group (22.2%) than SIVD group (45.8%) and control group (47.5%).When stratified by gender, among men, there were significant differences in the frequencies of 5-HTTLPR genotypes between SID, SIVD and control group (χ~2=9.848,P=0.043). The frequency of the SS genotype was higher in SID group (57.9%) than in SIVD group (15.4%) and control group (22.9%) (χ~2=8.934, P=0.011), while the frequency of the LS genotype was lower in SID group (26.3%) than in SIVD group (69.2%) and control group (54.3%) (χ~2=6.430, P=0.040).Among men, the frequency of the S allele was higher in SID group (71.1%) than SIVD group (50.0%) and control group (50.0%), while the frequency of the L allele was lower in SID group (28.9%) than SIVD group (50.0%) and control group(50.0%). There were no significant differences in the frequency of 5-HTTLPR allele between SID, SIVD and control group (χ~2=4.896,P=0.086).Among women, there were significant differences in the frequency of 5-HTTLPR genotypes between SID, SIVD and control group (χ~2=9.735,P=0.045). The frequency of the SS genotype was higher in SID group (82.4%) than in SIVD group (45.5%) and control group (36.0%) (χ~2=9.028, P=0.011), while the frequency of the LS genotype was lower in SID group (5.9%) than in SIVD group (27.3%) and control group (40.0%) (χ~2=6.065,P=0.048).Among women, the frequency of the S allele was higher in SID group (85.3%) than SIVD group (59.1%) and control group(56.0%), while the frequency of the L allele was lower in SID group (14.7%) than SIVD group (40.9%) and control group (44.0%). There were significant differences in the frequency of 5-HTTLPR allele between SID, SIVD and control group (χ~2=8.341,P=0.015).In multinomial Logistic regression models, there were no significant differences in the frequency of the SS allele between SIVD group and control group (OR=0.982,OR 95% CI=0.240～4.021), while there were significant differences in the frequency of the SS allele between SID group and control group (OR=4.610,OR 95% CI=1.361～15.613).Conclusions: There was an association between 5-HTTLPR and SID in Chinese Han, the presence of 5-HTTLPR allele S may increase the risk for SID, and old people with SS genotype had more risk for SID, which were observed with no significant difference between male and female. Objective: To examine the characteristics of cognitive impairment and related vascular risk factors in subcortical ischemic depression (SID) patients, and to provide evidence for clinical individualized therapy.Methods: A case-control study of 36 patients with SID, 24 patients with subcortical ischemic vascular disease no depression (SIVD) and 60 control subjects were conducted. Multinomial Logistic regression model was performed to examine the association between 5-HTTLPR and SID, SIVD, after adjusting for age, gender and education status. The mental health status was assessed using mini-mental state examination (MMSE), The Montreal Cognitive Assessment (MoCA) and Hamilton depression scale (HAMD). The partial correlation analyses were tested to examine the association between the scores of MoCA,MMSE,HAMD and the levels of blood pressure, serum lipids and blood glucose, after adjusting for age, gender and 5-HTTLPR genotypes. Unconditional Logistic regression model was performed to examine the association between 5-HTTLPR, related vascular risk factors and SID.Results: The MoCA scores were significantly higher in control group (27.25±1.59) than SIVD group (24.29±1.78) and SID (23.19±1.31) (F=85.046, P=0.000). The cognitive impairments were mainly on attention and delayed memory. The scores for attention item in SID, SIVD and control group were 4.25±0.84, 4.33±0.87 and 5.65±0.82, respectively (F=40.177, P=0.000), while the scores for delayed memory item in SID, SIVD and control group were 1.53±0.97, 2.00±1.29 and 3.93±1.04 respectively (F=65.411, P=0.000).In SID group, the partial correlation analyses showed a highly significant positive correlation between the MoCA scores and the MMSE scores (r=0.762, P=0.000), and a negative correlation between the MoCA scores and the HAMD scores (r=-0.715, P=0.000).A negative correlation was found between the MoCA scores and SBP,DBP,TG,TCH in SID group (P<0.05 for all), as well as LDL,VLDL and HDL (P>0.05 for all), while no correlation between the MoCA scores and FBG.A negative correlation was found between the MMSE scores and the HAMD scores, SBP and DBP in SID group (P<0.05 for all), as well as TG, TCH, LDL, VLDL, HDL, and FBP (P>0.05 for all).A positive correlation was found between the HAMD scores and SBP,DBP,TG,TCH,and HDL in SID group (P<0.05 for all), as well as LDL and VLDL (P>0.05 for all). A negative correlation was found between the HAMD scores and FBP (P>0.05).Multiple regression models were performed after adjusting for age, gender, education status and 5-HTTLPR genotypes, the results showed significant association between SID and history of hypertension, hyperlipemia and smoking, while no association between SID and diabetes history.Conclusions: Cognitive impairment could exist in many domains among SID and SIVD patients, which especially showed as damage of attention and delayed memory. The causes of SID could contributing to the history of hypertension, hyperlipemia and smoking, however not diabetes history. |
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