Correlations between Glucose-insulin Profiles and Serum Brain-derived Neurotrophic Factor Level in Patients with Major Depressive Disorder before and during Antidepressant Treatment

重鬱症病人治療前後的血糖、胰島素與腦源性神經營養因子的關係

楊孟凡(Meng Fan Yang) ； 張惠華(Hui Hua Chang) ； 紀美宏(Mei Hung Chi) ； 蔡幸君(Hsin Chun Tsai) ； 戴瀅純(Ying Chun Tai) ； 楊延光(Yen Kuang Yang) ； 陳柏熹(Po See Chen)

《台灣精神醫學》 32卷4期 (2018/12) Pp. 314-322+ii

摘要

Objective: Decreased activity of brain-derived neurotrophic factor (BDNF) in the brain can be associated with major depressive disorder (MDD). Moreover, BDNF is involved in the regulation of glucose-insulin homeostasis, which is also affected in patients with MDD. But whether any correlations exist between BDNF and glucose-insulin profiles in MDD patients remains unclear. Methods: Twenty-one drug-naïve MDD patients were enrolled. Glucose-insulin profiles and serum BDNF levels were collected at baseline, and following the 2nd week, 4th week, and 12th week of a course of fluoxetine treatment. Correlation analysis was adopted to investigate the results. Results: At baseline, the serum BDNF level was significantly and positively correlated with the insulin level (p ＜ 0.001), and homeostasis model assessment-estimated insulin resistance (HOMA-IR) index (p ＜ 0.001). The serum BDNF level was decreased at the 2nd and 4th weeks, but had returned to the baseline level at the 12th week. The change ratio of the serum BDNF level from baseline to the 4th week was inversely significantly correlated to the basal insulin level (r = -0.52, p ＜ 0.05), and positively significantly correlated to basal HOMA-IR index (r = -0.54, p ＜ 0.05). Conclusion: BDNF might be involved in glucose-insulin homeostasis in MDD patients receiving pharmacological treatment. In MDD, the dynamic rôles of BDNF in glucose-insulin homeostasis merit further investigation.

關鍵字

brain-derived neurotrophic factor ； depressive disorder ； insulin ； insulin resistance

並列摘要

目的：腦中腦源性神經營養因子(BDNF)的較少可能和重鬱症有關。除此之外腦源性神經營養因子也會影響血糖和胰島素的調節，而此也會影響重鬱症病人。然而血糖、胰島素與腦源性神經營養因子彼此之間是否有關仍未知。方法：21位未服藥重鬱症病人中，於基期、fluoxetine治療2週後、4週後與12週後收集血糖、胰島素與腦源性神經營養因子資料，並採用相關分析來探討彼此的關係。結果：基期時，腦源性神經營養因子和胰島素與胰島素抗性(HOMA-IR)有顯著的正相關(p ＜ 0.001)。腦源性神經營養因子於fluoxetine治療2週後與4週後下降，但於12週後又回復到初始值。腦源性神經營養因子4週的改變比率和基期的胰島素與胰島素抗性(HOMA-IR)有顯著的負相關(p ＜ 0.05)。結論：腦源性神經營養因子可能和重鬱症治療中的血糖與胰島素調節有關，而此動態調節的方式需要進一步研究。

並列關鍵字

腦中腦源性神經營養因子(BDNF) ； 憂鬱症 ； 胰島素 ； 胰島素抗性

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