| Objective:The levels of orexin in the peripheral blood of the depression group and the normal control group were compared,and the changes of orexin levels in the depression group before and after treatment were observed to explore the pathogenesis of depression.Methods:Meet the International Classification of Diseases 10(ICD-10)diagnostic criteria for depression episodes,17 versions of the Hamilton Depression Scale(HAMD)?24 points,aged between 18-60years,Normal dieters had a Body Mass Index(BMI)of 15.500-23.900 kg/m~2,no previous history of blood glucose and dyslipidemia,and no significant abnormalities in hematuria,liver and kidney function,electrocardiogram,blood glucose,and blood lipids.Forty-one patients were included in the study as the depression group;42 healthy volunteers were included as the normal control group.Peripheral blood was collected at the time of admission,at the 4th week of treatment,and at6am on the 8th week of treatment,and clinical data collection and scale assessment were performed on the same day.Enzyme-linked Immunosorbent Assay(ELISA)was used to detect serum orexin To compare the differences in orexin levels between the depression group and the normal control group and the differences in orexin levels before and after treatment in patients with depression group.Results:1.In this study,a total of 41 patients with depression were included as the depression group,and 42 healthy volunteers were included as the normal control group,of which 41 patients with depression completed 8weeks of treatment.There was no statistically significant difference in general demographic data between the depression group and the normal control group in terms of gender,age,smoking history,BMI,and years of education.The levels of orexin in the depression group and the healthy control group were analyzed using the Mann-Whitney U rank test.The median levels of Orexin-A and Orexin-B in the depression group were53.654 pg/mL and 66.141 pg/mL,and the median levels of Orexin-A and Orexin-B in the normal control group were 46.572 pg/mL and105.494 pg/mL.There was no significant difference between the two groups of Orexin-A(Z=-1.029,P=0.303);the serum level of Orexin-B in the depression group was lower than the normal control group,and the difference was statistically significant(Z=-5.383,P=0.000).2.The impact of general demographic and clinical data on orexin:According to gender,whether there is an etiology,family history,suicide history,smoking history,drinking history,whether the first episode,etc.,group patients with depression,use Mann-Whitney U rank Analysis with tests showed that the levels of Orexin-A and Orexin-B in patients with suicide history were higher than those without suicide history,and the difference was statistically significant(Z=-2.085,P=0.037;Z=-2.339,P=0.019).In addition,the level of Orexin-B in patients with first episodes was higher than those with relapses,and the difference was statistically significant(Z=-2.001,P=0.045);there was no significant difference in patients with or without causes,family history,smoking history,and drinking history.Significance(P>0.05).Spearman correlation analysis was used to analyze the correlations between age,BMI,education,total disease duration,and number of episodes with the levels of Orexin-A and Orexin-B in patients with depression,and no significant correlation was found(P>0.05).3.Spearman correlation analysis between baseline HAMD?PSQI score and Orexin-A?Orexin-B level in depression group,found no correlation between HAMD,PSQI score and serum Orexin-A level at baseline(r=-0.111,P=0.490;r=-0.950,P=0.553),and there was a significant negative correlation between HAMD,PSQI scores and serum Orexin-B levels at baseline(r=-0.385,P=0.013;r=-0.345,P=0.027).4.The HAMD scores for the depression group at baseline,4 weeks of treatment,and 8 weeks of treatment were 28.512±3.802?14.049±3.605?7.731±3.924,and the PSQI scores of the depression group at baseline,4 weeks of treatment,and 8 weeks of treatment were 15.595±2.588?10.292±3.156?4.756±2.853?Repeated measures analysis of variance showed significant differences in HAMD and PSQI scores before and after treatment(F=0.000,P=0.000).5.In the depression group,the levels of Orexin-A at baseline,at the end of treatment 4 and at the end of treatment 8 were 57.816±19.162pg/mL,58.170±20.708 pg/mL,78.750±29.309 pg/mL.The weekend levels were 73.526±27.200 pg/mL,78.750±29.309 pg/mL,and 92.846±27.323 pg/mL,respectively.Repeated measures analysis of variance showed no significant difference in Orexin-A levels before and after treatment(F=1.710,P=0.187),and Orexin-B levels increased significantly,the difference was statistically significant(F=30.988,P=0.000)?Conclusions:1.The level of Orexin-B in the depression group was significantly lower than that in the normal control group,suggesting that the decrease in Orexin-B level may be part of the cause of depression.2.With the improvement of symptoms in patients with depression,Orexin-B levels increased significantly,suggesting that increasedOrexin-B levels may lead to the improvement of depression symptoms. |
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