Study On The Correlation Between HPG、HPT Axis Hormones,CRP And P300 Latency And Neurocognition In Unipolar And Bipolar Depression

Objective:The distinction between unipolar depression(UD)and depression in bipolar disorder(BD)has always been a hot spot for researchers.This study tried to analyze the differences of hypothalamicpituitary-gonadal axis(HPG)hormones,hypothalamic-pituitary-thyroid axis(HPT)hormones,C-Reactive protein(C-reactive protein,CRP),P300 latency and neurocognitive function,and further study the correlation between neurocognitive function and HPG axis hormone,HPT axis hormone,CRP and P300 latency,try to distinguish UD and BD depression from different perspectives of neuroendocrine,Inflammatory factors,and neurophysiology.Method:Patients with unipolar and bipolar depression who were hospitalized in Shandong Mental Health Center from December 1,2019 to December 31,2020,based on the ICD-10 diagnostic criteria,were enrolled in this study.73 patients with unipolar depression were divided into the UD group,and 37 patients with bipolar depression were divided into the BD group.At the same time,75 cases of health controls from Shandong Mental Health Center and nearby community volunteers were assigned to the HC group.Fasting venous blood were collected from 7 am to 7:30 am the next day of admission to detect sex hormones,thyroid hormones,CRP and glycolipid indicators.On the next day of admission,patients completed the Self-Rating Depression Scale(SDS Scale)and Mo CA scale and all volunteers taked the P300 latency test of Event-related potentials(ERP).Results:1.The ages of the UD group and the BD group were significantly lower than those of the HC group(both P values were less than 0.05),and there was no significant difference between the ages of the UD group and the BD group;the abnormal rates of cognitive function in the UD group and the BD group were higher than the healthy control group(P The values are all less than 0.001),there is no significant difference in the rate of cognitive function abnormality between the UD group and the BD group.There were no significant differences in gender and BMI among the three groups.The duration of illness of the BD group was significantly longer than that of the unipolar depression group(P<0.001).The rate of first episode in UD group was significantly higher than that of BD group(P=0.003).There were no significant differences between the UD group and the BD group in gender,education,age at onset,family history of psychiatric disorder,BMI and abnormal rate of cognitive function.2.Mo CA: Mo CA total score,visual space and executive function,language,abstraction,memory,orientation scores of UD group and BD group were significantly lower than the HC group.The attention score of the BD group was significantly lower than the HC group.Mo CA total score,abstraction score of BD group were significantly lower than UD group(all P values were less than 0.05).3.HPG,HPT axis hormones,CRP and glycolipid levels: In general:the serum FT3 and FBG concentrations of the UD group and the BD group were significantly lower than the HC group,the serum FT3 concentration of the BD group was significantly lower than that of the UD group,and the serum FBG concentration of the BD group was significantly higher than that of the UD group.In the UD group,the serum HDL-C concentration of the UD group was significantly lower than that of the HC group(all P values were less than 0.05).There was no significant difference in serum HPG axis hormone and CRP concentration among the three groups.Female: Serum T concentration of BD group was significantly higher than that of UD group,serum FT4 concentration of UD group was significantly lower than that of HC group,serum FBG concentration of UD group and BD group were significantly lower than that of HC group,serum FBG concentration of BD group was significantly higher than that of UD group(All P values are less than 0.05).There were no significant differences in serum CRP and lipid concentrations among the three groups.Male: The serum LH concentration of the BD group was significantly higher than that of the UD group,the serum FT3 concentration of the UD group and the BD group were significantly lower than that of the HC group,and the serum FBG concentration of the UD group was significantly lower than that of the HC group(all P values were less than 0.05).There were no significant differences in serum CRP and blood lipid concentrations among the three groups.4.P300 latency: The P300 latency of the UD group and the BD group was significantly longer than that of the HC group,and the P300 latency of the BD group was significantly longer than that of the UD group(all P values were less than 0.05).5.Correlation between cognition and demographic date,clinical date,clinical scale scores,HPG,HPT axis hormones,CRP and P300 latency: the total score of Mo CA in the UD group was negatively correlated with age and age at onset,and positively correlated with family history of psychiatric disorder;the total score of Mo CA in the BD group was negatively correlated with age,age at onset,and BMI(all P values were less than 0.05).In the UD group,visual space and executive function were positively correlated with serum TSH concentration.Attention was negatively correlated with serum LH concentration,memory was positively correlated with serum PRL concentration,and orientation was positively correlated with serum LH concentration(all P values were less than 0.05).In the BD group,visual space and executive function were positively correlated with serum FT3 concentration.Attention was negatively correlated with serum T concentration,and language was negatively correlated with serum CRP concentration(all P values were less than 0.05).The total Mo CA score,language,and orientation of the UD group were negatively correlated with the P300 latency(all P values were less than 0.05).In the BD group,the total score of Mo CA,visual space and executive function,language,abstraction,memory,and orientation were negatively correlated with the P300 latency(all P values were less than0.05).The total score of Mo CA in the UD group was negatively correlated with the total score of HAMD-17,the original score of SDS,the standard score of SDS,anxiety/somatization,block,weight loss,and sleep;the visual space and executive function were negatively correlated with the total score of HAMD-17,the original score of SDS,the standard score of SDS,weight loss and sleep;language is negatively correlated with anxiety/somatization;abstraction is negatively correlated with HAMD-17 total score,the original score of SDS,the standard score of SDS and anxiety/somatization;memory is negatively correlated with sleep(all P values are less than 0.05).In the BD group,Mo CA total score and abstraction were negatively correlated with block;orientation was negatively correlated with HAMD-17 total score,the original score of SDS,the standard score of SDS,anxiety/somatization and sleep(all P values were less than 0.05).6.Influencing factors of cognitive impairment in the UD group:positive family history of psychiatric disorder and increased P300 latency were risk factors for cognitive impairment(β=1.411,OR=4.102,P=0.029;β=0.013,OR=1.013,P=0.011).Conclusion:1.Both the UD group and the BD group have different dimensions of cognitive impairment,and the BD group has more severe cognitive impairment than the UD group.2.In general,the serum FT3 level of the BD group was lower than that of the UD group,and the serum FBG level was higher than that of the UD group;among women,the serum T and FBG levels of the BD group were higher than those of the UD group;among men,the serum LH level of the BD group was higher than that of the UD group.3.Cognitive function of UD group and BD group were closely correlated with P300 latency.The longer the latency of P300 was,the more severe the impairment of cognitive function was.The P300 latency in the BD group was longer than that in the UD group.The P300 latency might be a potential biomarker of UD and BD.4.The cognitive function of the UD group was correlated with age,age at onset,family history of psychiatric disorder,TSH,LH,PRL and P300 latency;the cognitive function of the BD group was correlated with age,age at onset,BMI,T,FT3,CRP and P300 latency.5.The severity of depression had a certain impact on the cognitive function of patients with unipolar and bipolar depression.The more severe the depression was,the more severe the impairment of cognitive function was.6.Positive family history of psychiatric disorder and increased P300 latency were risk factors for cognitive impairment in UD.