Acta Psychiatrica Scandinavica:中国人群研究:肥胖与BDNF对双相障碍患者子女大脑结构的影响

2017-10-15 佚名 大话精神

脑源性神经营养因子(Brain Derived Neurotrophic Factor)是神经营养因子家族中重要的成员之一,在神经重塑机制中扮演重要角色。情感障碍的发生可能与神经脑网络对外界刺激的适应异常有关,有效的治疗方案可加强神经可塑性,使得神经脑网络结构对外界刺激有更为适宜的调整,因此,BDNF在双相障碍的发病机制中起重要作用。此外,BDNF参与糖和能量代谢的调节,以及参与肥胖的形成。

脑源性神经营养因子(Brain Derived Neurotrophic Factor)是神经营养因子家族中重要的成员之一,在神经重塑机制中扮演重要角色。情感障碍的发生可能与神经脑网络对外界刺激的适应异常有关,有效的治疗方案可加强神经可塑性,使得神经脑网络结构对外界刺激有更为适宜的调整,因此,BDNF在双相障碍的发病机制中起重要作用。此外,BDNF参与糖和能量代谢的调节,以及参与肥胖的形成。

对双相障碍子女和高危人群的研究有助于阐明双相障碍早期阶段的病理生理改变。目前有研究显示,双相障碍患者的子女(双相障碍高危人群)外周血BDNF水平较对照组高;高危人群的BDNF水平呈U型分布,即在青少年组有所降低,而在成年组中升高。对双相障碍患者子女进行的神经影像结构研究则提示,大脑特定区域存在异常,包括海马体、杏仁核、中间额下回、中颞回和楔前叶等区域。最近研究进一步提示,参与了快感和奖励/动机相关的行为的伏隔核也存在异常。本研究的目的是比较双相障碍患者子女和健康对照组的外周血BDNF水平;探索BDNF水平和体质指数(BMI)与大脑结构的关系。

方法

受试者包括来自医院接受住院与门诊治疗以及在社区精神卫生服务部门登记的双相障碍患者的子女(n=67)和 45名健康对照。采用3.0T核磁共振和酶联免疫法测定来获得所有入组成员的脑结构影像学数据和外周血BDNF的OD值,并测算BMI指数。采用学龄期儿童版及成人版情感障碍和精神分裂筛查量表(K-SADS-PL;SCID-I/P)及高年资医生进行的家庭访谈来对入组成员进行问卷筛查和评估。统计采用多变量和单变量协方差分析以及相关与偏相关分析来探讨BDNF、BMI与脑结构影响之间的关系。

结果

双相障碍患者子女较正常对照组的HAMD和YMRS总分显着增高;并且其BDNF水平显着高于正常对照组(p = 0.035);BMI值与BDNF水平在双相障碍患者子女中呈正相关,而在对照组中呈负相关。

将年龄、全脑体积作为协变量的回归分析模型发现,双相障碍患者子女的BDNF水平与左侧额下回眶部体积负相关(r=-0.268,p=0.012);进一步将年龄、颅内体积、性别、BMI、HAMD与YMRS量表分作为多变量回归分析后,结果显示BDNF水平对双侧小脑白质体积(p=0.012)、双侧额中叶灰质体积(p=0.024)、左侧额上回灰质体积(p=0.04)有显着影响。单因素回归模型分析发现。外周BDNF水平与全脑皮层体积(p=0.017)、白质体积(p=0.045)、灰质体积(p=0.022)在双相障碍子女组中呈负相关,而在正常对照组中呈正相关。

在双相障碍子女中, BDNF和体质指数对双侧伏隔核(左p=0.01;右p=0.007)的影响存在交互作用,但在健康对照组中未发现此关系。

结论

双相障碍子女外周血BDNF水平较健康对照组高,并且与体质指数呈正相关,结果表明BDNF与机体代谢关系密切。其次,BDNF水平与大脑结构的相关性受到体质指数的影响。此外,双相障碍子女的伏隔核等脑体积改变与BDNF水平和BMI的交互作用有关。本研究提示,在双相障碍高危人群中,控制体重、保持机体代谢平衡是预防其发病的一种重要干预措施。

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    2017-10-24 大爰

    学习了谢谢分享!!

    0

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    2017-10-18 yfjms

    学习了

    0

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    2017-10-17 apoenzyme
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encodeId=9275253246ab, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Mon Oct 16 00:08:40 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-17 wmr116
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    2017-10-16 sunfeifeiyang

    那就说胖子都该死啦

    0

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target=_blank style='color:#2F92EE;'>#脑结构#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85001, encryptionId=ab7e85001cf, topicName=脑结构)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f3114785325, createdName=wmr116, createdTime=Tue Oct 17 14:13:00 CST 2017, time=2017-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253353, encodeId=8174253353dc, content=那就说胖子都该死啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Mon Oct 16 09:13:08 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253246, encodeId=9275253246ab, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Mon Oct 16 00:08:40 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 飛歌

    学习了很有用

    0

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