围绝经期女性抑郁情绪调查及与肠道菌群平衡的相关性分析

Investigation on depression emotion of perimenopausal women and analysis of correlation of perimenopausal depression with intestinal flora balance

摘要

目的 探讨围绝经期女性抑郁情况及其与肠道菌群平衡的相关性。方法 选取2021年5月至2023年6月于河北医科大学第二医院体检中心进行健康体检的328名围绝经期女性为研究对象,按其有无抑郁情绪分为抑郁组(有抑郁情绪)、无抑郁组(无抑郁情绪)。采用一般资料调查问卷、知觉压力量表(PSS)、抑郁自评量表(SDS)、简明应对方式问卷(SCSQ)、心理弹性量表(CD-RISC)、改良 Kupperman评分量表、领悟社会支持量表(PSSS)、腹胀程度评分进行调查分析,采用 Lasso回归、Logistic回归方程分析围绝经期女性抑郁情绪影响因素,采用Spearman相关分析肠道菌群平衡与抑郁情绪的相关性。结果 围绝经期女性抑郁情绪发生率为31.40% (103/328);高社会支持水平、积极 SCSQ 评分>22.20 分、CD-RISC 评分>82.14 分、5-羟色胺(5-HT)水平>0.92 ng/mL、雌二醇水平>135.46 pmol/L 是围绝经期女性产生抑郁情绪的保护因素(OR 值介于0.316~0.990之间,P<0.05),知觉压力水平过大、消极SCSQ 评分>15.12分、围绝经期症状程度重度是围绝经期女性产生抑郁情绪的危险因素(OR 值介于3.882~6.169之间,P<0.05);抑郁组双歧杆菌值低于无抑郁组,肠杆菌值、腹胀程度评分高于无抑郁组,差异有统计学意义( t值介于7.454~17.705之间,P<0.05);双歧杆菌值与抑郁情绪呈负相关性,肠杆菌值、腹胀程度评分与抑郁情绪呈正相关性(r 值分别为-0.621、0.614、0.724,P<0.05)。结论 围绝经期女性抑郁情绪发生率较高,社会支持水平、知觉压力水平、应对方式、围绝经期症状严重程度、雌二醇、5-羟色胺水平是围绝经期女性抑郁情绪的影响因素,且抑郁情绪与双歧杆菌值负相关,与肠杆菌值、腹胀程度评分正相关;临床可据此制定相关应对措施,保障围绝经期女性身心健康。

Abstract

Objective To investigate depression emotion in perimenopausal women and its correlation with intestinal flora balance. Methods A total of 328 perimenopausal women who underwent physical examination in Physical Examination Center of The Second Hospital of Hebei Medical University from May 2021 to June 2023 were selected as study subjects.They were divided into depression group and non-depression group according to whether the perimenopausal woman had depression emotion.General information questionnaire,Perceived Stress Scale (PSS),Self-rating Depression Scale (SDS),Simplified Coping Style Questionnaire (SCSQ),Connor-Davidson Resilience Scale (CD-RISC),Modified Kupperman Rating Scale,Perceived Social Support Scale (PSSS),and abdominal distension scoring were used for investigation and analysis.Lasso regression and Logistic regression equation analyses were used to analyze influencing factors of depression emotion in perimenopausal women.Spearman correlation was used to analyze correlation between intestinal flora balance and depression emotion. Results The incidence of depression emotion in perimenopausal women was 31.40% (103/328).High social support level,positive SCSQ score > 22.20 points,CD-RISC score > 82.14 points,serum 5-hydroxytryptamine (5-HT) level > 0.92 ng/mL,and serum estradiol level > 135.46 pmol/L were protective factors for occurrence of depression emotion in perimenopausal women (OR =0.316-0.990,all P <0.05).Excessive perceived stress level,negative SCSQ score>15.12 points and severe perimenopausal symptoms were risk factors for occurrence of depression emotion in perimenopausal women (OR=3.882-6.169,all P<0.05).The bifidobacterium value in the depression group was lower than that in the non-depression group,and the enterobacterium value and score in abdominal distension were higher than those in the non-depression group,and the differences were statistically significant ( t=7.454-17.705,all P<0.05).Bifidobacterum value was negatively correlated with depression mode,while enterobacterium value and abdominal distension score were positively correlated with depression emotion (r= -0.621,0.614 and 0.724 respectively,all P <0.05). Conclusion The incidence of depression emotion in perimenopausal women is high.Social support level,perceived stress level,coping style,severity of perimenopausal symptoms,serum estradiol and 5-HT levels are influencing factors of depression emotion in perimenopausal women.Perimenopausal depression emotion is negatively correlated with bifidobacterum value,and positively correlated with Enterobacterium value and abdominal distension score.Clinically,relevant countermeasures can be formulated accordingly to ensure the physical and mental health of perimenopausal women.

关键词

围绝经期 / 抑郁 / 肠道菌群 / 影响因素 / 相关性

Key words

perimenopause / depression / intestinal flora / influencing factor / correlation

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基金资助

河北省重点研发计划项目(20210131108D)