Relationship of the Risk of Adulthood Depression with Serum CRP，IP-10，TGF-β1 and Childhood Trauma：a Case-control Study

doi:10.12114/j.issn.1007-9572.2021.00.160

Abstract

Abstract: Background　Cytokine hypothesis is one of the most important theories of the mechanism of depression.Numerous studies have suggested that childhood trauma was closely relevant to the occurrence of depression.Knowing the relationship of serum indices，and childhood trauma with depression might provide a theoretical basis for further studies of the pathogenesis.Objective　To investigate the relationships of serum CRP，IP-10，TGF-β1 levels and childhood trauma with the risk of adulthood depression.Methods　A case-control study design was adopted in this study with 48 adult patients with depression and 51 healthy adult controls from Mental Health Department，The Second Affiliated Hospital of Guangxi Medical University were included during May 2018 to May 2019.Serum CRP，IP-10 and TGF-β1 levels were measured by double-antibody sandwich ELISA.The 28-item Childhood Trauma Questionnaire-Short Form was used to assess childhood trauma.Multivariate Logistic regression was used to identify the risk factors of adulthood depression.Results　Compared with control group，the case group showed significantly lower average level of TGF-β 1（P<0.01），and higher scores of emotional abuse，physical abuse，sexual abuse and emotional neglect（P<0.05）.Logistic regression analysis showed that lower level of serum TGF-β1，low level of serum TGF-β1，emotional abuse，physical abuse，sexual abuse and emotional neglect increased the risk of depression（OR=5.60，7.86，11.20，7.62，4.43，3.34，P<0.05）.Conclusion　Serum TGF-β1 levels and childhood trauma experience might have impact on the risk of depression in adulthood.

Key words: Depressive disorder, Transforming growth factor beta1, C-reactive protein , Interferon-inducible protein-10, Childhood trauma, Case-control studies

摘要： 背景　细胞因子假说是抑郁症的重要发病机制学说之一，目前也有大量研究发现抑郁症的发病与童年期的创伤经历有密切关系，了解其对抑郁症发病的影响，为抑郁症发病机制研究进一步提供理论参考依据。目的　探讨血清C反应蛋白（CRP）、干扰素诱导蛋白10（IP-10）、转化生长因子β1（TGF-β1）水平和童年期创伤与抑郁症发病风险的关系。方法　选取2018年5月—2019年5月在广西医科大学第二附属医院心理卫生科就诊的47例抑郁症患者作为病例组，同期在该医院体检部招募健康志愿者51例作为对照组。以双抗体夹心法酶联免疫吸附试验（ELISA）测定血清CRP、IP-10、TGF-β1水平，应用28项简版童年期创伤问卷（CTQ-SF）评估研究对象童年期创伤情况。采用多因素Logistic回归分析探讨抑郁症发病风险因素。结果　病例组血清TGF-β1水平低于对照组（P<0.01）。病例组情感虐待得分、躯体虐待得分、性虐待得分、情感忽视得分高于对照组（P<0.05）。多因素Logistic回归分析结果显示，较低水平TGF-β1（OR=5.60，P<0.05）和低水平TGF-β1（OR=7.86，P<0.05）、情感虐待阳性（OR=11.20，P<0.05）、躯体虐待阳性（OR=7.62，P<0.05）、性虐待阳性（OR=4.43，P<0.05）以及情感忽视阳性（OR=3.34，P<0.05）可能为抑郁症发病的危险因素。结论　血清TGF-β1水平、童年期创伤经历可能对抑郁症发病的风险有影响。

关键词: 抑郁症, 转化生长因子&beta, 1, C反应蛋白, 干扰素诱导蛋白10, 童年期创伤, 病例对照研究

PAN Yuli,ZENG Xuan,LIN Xiujin, et al. Relationship of the Risk of Adulthood Depression with Serum CRP，IP-10，TGF-β1 and Childhood Trauma：a Case-control Study　[J]. Chinese General Practice, 2021, 24(11): 1349-1353. DOI: 10.12114/j.issn.1007-9572.2021.00.160.
潘玉立,曾烜,林秀金等. 血清CRP、IP-10、TGF-β1水平和童年期创伤与抑郁症发病风险关系的病例对照研究[J]. 中国全科医学, 2021, 24(11): 1349-1353. DOI: 10.12114/j.issn.1007-9572.2021.00.160.

References

［1］MAES M.Evidence for an immune response in major depression：a review and hypothesis［J］．Prog Neuropsychopharmacol Biol Psychiatry，1995，19（1）：11-38．DOI：10.1016/0278-5846（94）00101-m.
［2］刘钊，陈建军，周健，等．血液C-反应蛋白水平与抑郁症关系的系统评价［J］．重庆医科大学学报，2015，40（1）：60-65．DOI：10.13406/j.cnki.cyxb.000311.
LIU Z，CHEN J J，ZHOU J，et al．Association of blood C-reactive protein with depression：a systematic review［J］．Journal of Chongqing Medical University，2015，40（1）：60-65．DOI：10.13406/j.cnki.cyxb.000311.
［3］梁星辰，姜会梨，张丹妹，等．电针对慢性应激抑郁模型大鼠海马CXCR4和IP-10蛋白表达的影响［J］．北京中医药大学学报，2017，40（10）：872-875．DOI：10.3969/j.issn.1006-2157.2017.10.014.
LIANG X C，JIANG H L，ZHANG D M，et al．Effects of electro-acupuncture in hippocampal CXCR4 and IP-10 protein expression in rats with depression disorder［J］．Journal of Beijing University of Traditional Chinese Medicine，2017，40（10）：872-875．DOI：10.3969/j.issn.1006-2157.2017.10.014.
［4］MYINT A M，LEONARD B E，STEINBUSCH H W，et al．Th1，Th2，and Th3 cytokine alterations in major depression［J］．J Affect Disord，2005，88（2）：167-173．DOI：10.1016/j.jad.2005.07.008.
［5］王蕾蕾，宋崇升，石超，等．童年期创伤与抑郁症的关系［J］．中华行为医学与脑科学杂志，2019，28（5）：476-480．DOI：10.3760/cma.j.issn.1674-6554.2019.05.018.
WANG L L，SONG C S，SHI C，et al．The relationship between childhood trauma and depression［J］．Chinese Journal of Behavioral Medical and Brain Science，2019，28（5）：476-480．DOI：10.3760/cma.j.issn.1674-6554.2019.05.018.
［6］黄庆玲，雍那，胡华，等．抑郁症患者应对方式与童年受虐经历的关系［J］．重庆医学，2015，44（5）：613-615．DOI：10.3969/j.issn.1671-8348.2015.05.012.
HUANG Q L，YONG N，HU H，et al．Relationship between coping styles of patients with depression and childhood abuse［J］．Chongqing Medicine，2015，44（5）：613-615．DOI：10.3969/j.issn.1671-8348.2015.05.012.
［7］宫翠风，王惠萍，尉秀峰，等．童年期创伤性经历与青少年抑郁症的关系［J］．中国健康心理学杂志，2016，24（7）：1076-1079．DOI：10.13342/j.cnki.cjhp.2016.07.031.
GONG C F，WANG H P，WEI X F，et al．The relationship between childhood traumatic experiences and adolescent depression［J］．China Journal of Health Psychology，2016，24（7）：1076-1079．DOI：10.13342/j.cnki.cjhp.2016.07.031.
［8］美国精神医学学会.精神障碍诊断与统计手册［M］．第５版.北京：北京大学出版社，2015：149-180.
American Psychiatric Asssociation.Diagnostic and statistical manual of mental disorders fifth edition［M］．Beijing：Peking University Press，2015：149-180.
［9］傅文青，姚树桥，于宏华，等．儿童期创伤问卷在中国高校大学生中应用的信效度研究［J］．中国临床心理学杂志，2005，13（1）：40-42．DOI：10.16128/j.cnki.1005-3611.2005.01.012.
FU W Q，YAO S Q，YU H H，et al．Initial reliability and validity of Childhood Trauma Questionnaire（CTQ-SF） applied in Chinese college students［J］．Chinese Journal of Clinical Psychology，2005，13（1）：40-42．DOI：10.16128/j.cnki.1005-3611.2005.01.012.
［10］王雪云，施星明，赵慧玲，等．中文版儿童期创伤问卷在精神障碍患者中信度、效度分析［J］．中国健康心理学杂志，2018，26（4）：618-622．DOI：10.13342/j.cnki.cjhp.2018.04.035.
WANG X Y，SHI X M，ZHAO H L，et al．Reliability and validity of chinese version of childhood trauma questionnaire in patients with mental disorders［J］．China Journal of Health Psychology，2018，26（4）：618-622．DOI：10.13342/j.cnki.cjhp.2018.04.035.
［11］TUCCI A M，KERR-CORRêA F，SOUZA-FORMIGONI M L.Childhood trauma in substance use disorder and depression：an analysis by gender among a Brazilian clinical sample［J］．Child Abuse Negl，2010，34（2）：95-104．DOI：10.1016/j.chiabu.2009.07.001.
［12］DAVIDSON G，SHANNON C，MULHOLLAND C，et al．A longitudinal study of the effects of childhood trauma on symptoms and functioning of people with severe mental health problems［J］．J Trauma Dissociation，2009，10（1）：57-68．DOI：10.1080/15299730802485169.
［13］MUSIL R，SCHWARZ M J，RIEDEL M，et al．Elevated macrophage migration inhibitory factor and decreased transforming growth factor-beta levels in major depression——no influence of celecoxib treatment［J］．J Affect Disord，2011，134（1/2/3）：217-225．DOI：10.1016/j.jad.2011.05.047．
［14］潘玉芹，林文娟.细胞因子和抑郁症［J］．心理科学进展，2006，14（06）：901-906．DOI：10.3969/j.issn.1671-3710.2006.06.016.
PAN Y Q，LIN W J.Cytokines and Depression［J］．Advances in Psychological Science，2006，14（6）：901-906．DOI：10.3969/j.issn.1671-3710.2006.06.016.
［15］许明敏，张丹妹，史榕荇，等．电针对慢性应激抑郁大鼠海马转化生长因子β3和碱性成纤维细胞生长因子表达的影响［J］．针刺研究，2016，41（2）：138-143．DOI：10.13702/j.1000-0607.2016.02.008.
XU M M，ZHANG D M，SHI R X，et al．Effect of electroacupuncture intervention on behavior changes and levels of hippocampal transforming growth factor beta 3 and basic fibroblast growth factor proteins in depression rats［J］．Acupuncture Research，2016，41（2）：138-143．DOI：10.13702/j.1000-0607.2016.02.008.
［16］TANG C Z，YANG J T，LIU Q H，et al．Up-regulated miR-192-5p expression rescues cognitive impairment and restores neural function in mice with depression via the Fbln2-mediated TGF-β1 signaling pathway［J］．FASEB J，2019，33（1）：606-618．DOI：10.1096/fj.201800210RR.
［17］姜洁，张捷，尹科，等．青年首发抑郁症患者血清IFN-γ、IL-4、TGF-β1、IL-9、IL-17水平检测及分析［J］．国际检验医学杂志，2017，38（6）：729-731．DOI：10.3969/j.issn.1673-4130.2017.06.004.
JIANG J，ZHANG J，YIN K，et al．Observation on serum IFN-γ，IL-4，TGF-β1，IL-9 and IL-17 levels from youth patients with first episode depression［J］．International Journal of Laboratory Medicine，2017，38（6）：729-731．DOI：10.3969/j.issn.1673-4130.2017.06.004.
［18］ROMMEL J，SIMPSON R，MOUNSEY J P，et al．Effect of body mass index，physical activity，depression，and educational attainment on high-sensitivity C-reactive protein in patients with atrial fibrillation ［J］．Am J Cardiol，2013，111（2）：208-12．DOI：10.1016/j.amjcard.2012.09.017.
［19］SONG J M，MIN J A，HUH H J，et al．Types of childhood trauma and spirituality in adult patients with depressive disorders［J］．Compr Psychiatry，2016，69：11-19．DOI：10.1016/j.comppsych.2016.04.003.
［20］TUNNARD C，RANE L J，WOODERSON S C，et al．The impact of childhood adversity on suicidality and clinical course in treatment-resistant depression［J］．J Affect Disord，2014，152/153/154：122-130．DOI：10.1016/j.jad.2013.06.037.
［21］王莹，杨建立，焦清艳.儿童期虐待对伴焦虑的抑郁障碍患者临床症状及个性特征的影响［J］．中华行为医学与脑科学杂志，2015，24（5）：451-454．DOI：10.3760/cma.j.issn.1674-6554.2015.05.017.
WANG Y，YANG J L，JIAO Q Y.Childhood abuse impact on clinical and personality characters among anxiety associated depressive patients［J］．Chinese Journal of Behavioral Medical and Brain Science，2015，24（5）：451-454．DOI：10.3760/cma.j.issn.1674-6554.2015.05.017.
［22］MANDELLI L，PETRELLI C，SERRETTI A.The role of specific early trauma in adult depression：a meta-analysis of published literature.Childhood trauma and adult depression［J］．Eur Psychiatry，2015，30（6）：665-680．DOI：10.1016/j.eurpsy.2015.04.007.

[1]	YAN Wen, ZHANG Hanzhi, JIN Hua, QIAN Jie, YU Dehua. Study on the Diagnosis and Treatment Capacity for Depressive Disorders in Community Health Service Institutions in Shanghai [J]. Chinese General Practice, 2026, 29(20): 2790-2799.
[2]	NIE Jiahui, LI Guojuan, HAO Zhuoqun, DU Qiaorong, LIU Penghong, LIU Zhifen, LIU Sha, ZHANG Aixia, WANG Yanfang. Heterogeneity and Influencing Factors of Cognitive Function Impairment in Patients with Major Depressive Disorder [J]. Chinese General Practice, 2026, 29(17): 2340-2346.
[3]	YU Chao, SONG Lihua, WANG Linyan, LU Yunping, WANG Linyang, CUI Wei. The Functional Outcomes and Influencing Factors in Patients with First-episode Major Depressive Disorder after 7 Years [J]. Chinese General Practice, 2026, 29(16): 2221-2226.
[4]	YAO Dingye, LUO Guiping, SUN Junsheng, LI Hui. Research Progress on Identifying Bipolar Ⅱ Disorder and Depressive Disorder in Primary Care [J]. Chinese General Practice, 2026, 29(15): 2092-2099.
[5]	LI Juexi, LI Liyuan, GUO Yuxuan, XIAO Xiaoqiang, TANG Peiqi, PU Ting, ZUO Haixi, YANG Ting, FAN Xiaoxia, ZHOU Bo. The Childhood Trauma and Adolescent Internet Addiction: the Chain Mediation of Depression Symptoms and Academic Burnout and the Moderating Role of Gender [J]. Chinese General Practice, 2026, 29(07): 900-906.
[6]	FAN Xueming, YANG Ningning, ZHENG Zheng, WU Yumei, WANG Qi. Analysis of Correlation Factors and Predictive Value of Microvascular Complications in Patients with Type 2 Diabetes Mellitus Combined with Metabolic-associated Fatty Liver Disease [J]. Chinese General Practice, 2025, 28(36): 4578-4585.
[7]	LIU Ruiyue, YANG Xuemei, ZHAO Naihui, WEN Xinran, CAI Xi, LIANG Yajing, MA Jiajia, WU Shouling, CUI Liufu. The Impact of the Ratio of High-sensitivity C-reactive Protein to Albumin on Incident Cardiovascular Disease in Different Age Groups: a Cohort Study [J]. Chinese General Practice, 2025, 28(36): 4566-4577.
[8]	YANG Handan, QIAO Wen, HE Shu, CHEN Yi, TONG Yunmei. The Impact of Acceptance and Commitment Therapy Combined with Sertraline on Depressive Mood, Suicidal Ideation, and Sleep Quality of Adolescents with Depression [J]. Chinese General Practice, 2025, 28(22): 2813-2818.
[9]	ZHANG Qi, HE Shen, LI Hua. Interpretation of Screening for Depression and Suicide Risk in Children and Adolescents: US Preventive Services Task Force Recommendation Statement 2022 [J]. Chinese General Practice, 2025, 28(15): 1823-1830.
[10]	ZHAO Lili, LIU Lewei, GENG Feng, MO Daming, LIU Huanzhong. The Relationship between Suicidal Ideation and Childhood Trauma in Adolescents with Depressive Disorder: the Dual Mediating Effects of Depressive Symptom Severity and Low Vitamin D Levels [J]. Chinese General Practice, 2025, 28(13): 1614-1621.
[11]	MA Juan, MA Shengzong, YAN Ru, MA Xueping, JIA Shaobin. Predictive Effect of C-reactive Protein Albumin Ratio on Long-term Adverse Cardiovascular Events in Patients with Type 2 Diabetes Mellitus and Acute Myocardial Infarction [J]. Chinese General Practice, 2025, 28(06): 705-712.
[12]	ZHANG Pingshu, XUE Jing, XING Aijun, WANG Lianhui, MA Qian, FU Yongshan, YUAN Xiaodong. Study on Sleep Status and Prognostic Factors in Patients with Acute Posterior Circulation Ischemic Stroke [J]. Chinese General Practice, 2025, 28(05): 548-553.
[13]	FAN Haojie, LIU Lewei, XIA Lei, TIAN Yinghan, YANG Cheng, HAO Mingru, ZHAO Xin, SHEN Qingqing, MO Daming, GENG Feng, LIU Huanzhong. Correlation of Non-suicidal Self-injury with 25-Hydroxyvitamin D₃ and Blood Lipid Levels in Adolescents with Major Depressive Disorder [J]. Chinese General Practice, 2025, 28(05): 612-618.
[14]	GUO Zhichao, CUI Dan, BAO Jiajun, SHI Weiqing, WEI Kang, YANG Xingtang, YU Wenya. The Influence of Family Cognitive Environment on Early Childhood Language Development: a Retrospective Case-control Study in Shanghai [J]. Chinese General Practice, 2025, 28(01): 53-58.
[15]	CHEN Ruman, BAI Yafei, WANG Chunli, AN Na, XU Mingzhi, HE Jiqing, QI Yonghui, WANG Liheng, LI Hong. Combined Predictive Value of Neutrophil-to-lymphocyte Ratio and C-reactive Protein-to-albumin Ratio for All-cause Mortality Risk in Patients with Maintenance Hemodialysis: Cohort Study Followed for 5 Years [J]. Chinese General Practice, 2024, 27(35): 4397-4402.