Depression And Serum Levels Of BDNF In Patients With Acne Vulgaris

Objective:The aim of this study is to investigate prevalence of depression symptoms,analyze its risk factors in patients with acne vulgaris,and explore its potential association with brain-derived neurotrophic factor(BDNF)levels,find biomarker for acne vulgaris with depression symptoms.Methods:1.One hundred and eighteen consecutive patients aged 18-24 years,who met the diagnostic criteria for acne vulgaris and were admitted to the department of dermatology outpatient at the Affiliated Hospital of Southwest Medical University,China within a 6-months period from January to June 2017 were recruited for test group.Fifty-nine healthy cases were assigned to the healthy control group.There was no significant difference in gender composition ratio and age between the two groups(χ2=1.021,P>0.05),(z=0.324,P>0.05).2.Informed consent was obtained after providing verbal and written information to participants or nearest relatives when relevant.The basic information of two groups were collected through a self-made general condition questionaire,including age,gender,and economic status(define family monthly income per capita≥3000 as good economic situation),studying and working conditions(dropping out from school and currently unemployed),family history of acne.For acne patients,the course of the disease,isotretinoin and antibiotics usage(history treatment with oral antibiotics for more than two weeks or with isotretinoin more than four weeks in past three months)were also recorded.The severity of acne were assessed by the GAGS.AIS and PHQ-9 score in two groups were evaluated by two dermatologists who had completed the psychological scale rating standard training.Depression symptoms were defined as PHQ-9≧10.The quality of life in acne group were also assessed by DLQI.3.Blood samples from all volunteers with acne vulgaris were harvested in the morning.The measurement of BDNF was performed by ELISA.The content of IL-6 and TNF-a in serum were determined by RIA.4.Statistical analyses: Results are expressed as percentages for categorical variables and as medians(interquartiLe ranges,IQR)for the continuous variables.Proportions were compared using the Chi-square test.Two-group comparison of continuous data was performed using the Mann–Whitney U test,and analysis of variance(ANOVA)was used for three-group comparison of continuous data.Spearman’s Rank correlation was used for bivariate correlations.The relationship of serum BDNF with depression was investigated using logistic regression models.Further,receiver operating characteristic curves(ROC)were used to test the overall diagnostic accuracy of the BDNF.All statistical analyses wre performed with SPSS 22.Results: 1.Defined as PHQ-9≧10,depression symptoms was identified in 20 acne vulgaris patients(17%).2.Patients with depression showed lower serum BDNF levels compared with patients without depression and controls(z=4.498,4.533,P<0.001).There were no difference in serum BDNF levels between normal controls and acne vulgaris patients without depressive symptoms(z=0.964,P>0.05).There was a negative correlation between levels of BDNF and the PHQ-9 scores(r=-0.486,P<0.001)in acne vulgaris patients.3.Lower serum BDNF levels was a risk factor for acne vulgaris patients with depression symptoms(OR 0.531,95%CI: 0.360-0.784;P<0.05).Other risk factors include dropping out from school and currently unemployed(OR 9.313,95%CI: 1.332-65.121;P<0.05),lower famiLy economic level(OR 6.995,95%CI: 1.517-32.258;P<0.05),high AIS scores(OR 1.532,95% CI: 1.181-1.989;P<0.05).4.Based on the ROC curve,with the area under the ROC curve at 0.82(95%CI: 0.714–0.925,P<0.001),the optimal cutoff value of serum BDNF levels as an indicator for screening of depression was estimated to be 12.275 ng/ml,which yielded a sensitivity of 72% and a specificity of 85%.With an AUC of 0.82,the diagnostic value of BDNF was significantly higher than AIS score(AUC 0.817 [0.717–0.917],P < 0.001),DLQI score(AUC 0.682 [0.555–0.810],P < 0.05).Conclusion: 1.Compared with healthy controls depression is more encountered in acne vulgaris patients.2.Lower serum BDNF,dropping out from school and currently unemployed,lower family economic levels,and poor sleep quality are risk factors for acne with depression.3.Serum BDNF levels are decreased in acne vulgaris patients with depression.Serum BDNF levels could serve as a novel predictor for depression in acne vulgaris patients.