Study On The Relationship Between Anxiety And Depression And The Expression Of Plasma ?-Endorphin And Calcitonin Gene-Related Peptide In Patients With Vitiligo

Objective: to compare the anxiety and depression scores and the expression of plasma ?-endorphin and calcitonin gene-related peptide(CGRP)between patients with vitiligo and normal controls,and to analyze the role of psychosocial factors and ?-endorphin and calcitonin gene-related peptide in the pathogenesis of vitiligo and their correlation.Methods: 85 patients with vitiligo diagnosed in the outpatient clinic of Wuhan first Hospital from January 2019 to October 2019 were selected as the case group and 100 healthy subjects as the control group.Hamilton anxiety scale(HAMA),Hamilton Depression scale(HAMD)and symptom Checklist 90(SCL-90)were used to evaluate the emotional score,anxiety or depression symptoms and their severity of the two groups.The levels of plasma ?-endorphin and CGRP in the two groups were detected by double antibody sandwich ELISA method to explore the correlation between neuropsychiatric factors and the changes of plasma ?-endorphin and CGRP in the pathogenesis and course of vitiligo.Results: The plasma levels of ?-endorphin and CGRP in patients with vitiligo were(23.82±14.16)pg/ml and(78.19±22.89)pg/ml,which were significantly higher than those in healthy control group(13.01±4.85)pg/ml and(52.78±12.21)pg/ml,with significant differences between the two groups(P < 0.01).The scores of HAMA,HAMD and SCL-90 in patients with vitiligo were also higher than those in healthy controls,and there was significant difference between the two groups(P < 0.01).In the case group,the plasma levels of ?-endorphin and CGRP in progressive patients were(25.45±15.1)pg/ml and(82.04±21.49)pg/ml,which were significantly higher than those in stable patients(18.55±8.94)pg/ml and(65.68±23.35)pg/ml,with significant differences between the two groups(P < 0.01).The plasma levels of ?-endorphin in patients with progressive and stable stage were significantly higher than those in healthy controls,and the level of plasma CGRP in patients with progressive stage was significantly higher than that in healthy controls(P < 0.01),but there was no significant difference between patients in stable stage and healthy controls(P > 0.05).The plasma levels of ?-endorphin and CGRP in patients with segmental type were(30.11±18.95)pg/ml and(87.7±20.12)pg/ml,which were significantly higher than those in patients with vulgaris(19.64±7.4)pg/ml and(71.85±22.59)pg/ml,with significant differences between the two groups(P < 0.01).The levels of plasma ?-endorphin and CGRP in patients with vulgaris and segmental type were significantly higher than those in healthy controls(P < 0.01).The plasma levels of ?-endorphin and CGRP in patients with vitiligo were positively correlated with the scores of HAMA,HAMD and SCL-90(r = 0.40,0.31,0.25,0.27,0.53,0.52,p < 0.01),and the levels of ?-endorphin and CGRP were also positively correlated(r = 0.64,p < 0.01).Conclusion: 1.The scores of anxiety,depression and symptoms in patients with vitiligo were significantly higher than those in the control group,indicating that patients with vitiligo had anxiety and depression.2.The expression levels of ?-endorphin in vulgaris,segmental,progressive and stable stage was higher than that in the normal control group,suggesting that ?-endorphin may be related to the pathogenesis of vitiligo.3.The scores of anxiety and depression in patients with vitiligo were positively correlated with the levels of plasma ?-endorphin and CGRP.It is speculated that there is an interaction between ?-endorphin,CGRP and mental factors of anxiety and depression.