预测系统性红斑狼疮患者的焦虑和抑郁：炎症、社会人口学变量和临床因素的作用

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-04-09 DOI:10.1016/j.semarthrit.2025.152718

Margot Sigel , Carolina Muñoz-Grajales , Michelle L. Barraclough , Juan P Diaz-Martinez , Mahta Kakvan , Roberta Pozzi Kretzmann , M Carmela Tartaglia , Lesley Ruttan , May Y Choi , Simone Appenzeller , Dennisse Bonilla , Patricia Katz , Dorcas E. Beaton , Robin Green , Dafna D. Gladman , Joan E. Wither , Alastair J. Flint , Zahi Touma , Kathleen S. Bingham

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引用次数: 0

摘要

目的明确系统性红斑狼疮（SLE）患者抑郁和焦虑的特异性促炎介质（分析物）的作用，是阐明这些致残症状机制的关键一步。本研究的目的是调查i) SLE患者队列中抑郁和焦虑症状与相关临床和社会人口学变量以及神经炎症相关分析物之间的关系，以及ii)包括这些社会人口学、临床和生物学变量的模型区分有无临床显著抑郁或焦虑的SLE患者的能力。方法：这是一项对SLE患者认知纵向研究参与者基线数据的横断面研究（N = 238）。我们通过随机森林研究了与神经炎症、相关社会人口统计学和临床变量相关的一组分析物的血清浓度与i)抑郁（用贝克抑郁量表测量- ii）和焦虑（用贝克焦虑量表测量）评分之间的关系，以及临床显著抑郁和焦虑症状（用SLE验证的截止分数定义）之间的关系。我们使用混淆矩阵从这些模型生成模型性能统计数据。结果SLE病程对抑郁的影响最大，分析物MMP-9的浓度对抑郁的影响较小。焦虑受分析物NGAL和IFN- Ɣ影响最大，其他变量影响较小。多变量模型的auc分别为0.85（抑郁）、0.77（焦虑）和0.82（抑郁和焦虑）。结论本探索性研究的发现提供了预测SLE患者抑郁和焦虑症状的潜在模型。这为进一步的研究奠定了基础，建立了一个概念模型来解释SLE中这些以患者为中心的重要结果的机制。

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Predicting anxiety and depression in systemic lupus erythematosus: the role of inflammation, sociodemographic variables and clinical factors

Objectives

Characterizing the contribution of specific pro-inflammatory mediators (analytes) to depression and anxiety in systemic lupus erythematosus (SLE) is a crucial step in illuminating the mechanisms of these disabling symptoms. The aims of this study were to investigate i) the relationship between depression and anxiety symptoms with relevant clinical and sociodemographic variables and neuroinflammation-associated analytes in a cohort of SLE patients, and ii) the ability of models including these sociodemographic, clinical and biological variables to discriminate between SLE patients with and without clinically significant depression or anxiety.

Methods

This is a cross-sectional study of baseline data from participants enrolled in a longitudinal study of cognition in SLE (N = 238). We examined the relationship between serum concentrations of a group of analytes associated with neuroinflammation, relevant sociodemographic and clinical variables and i) depression (measured with the Beck Depression Inventory-II) and anxiety (measured with the Beck Anxiety Inventory) scores, as well as between clinically significant depression and anxiety symptoms (defined using cut-off scores validated in SLE) via random forests. We generated model performance statistics from these models using confusion matrices.

Results

Depression is most influenced by duration of SLE and, to a lesser extent, concentrations of the analytes MMP-9. Anxiety is most influenced by the analytes NGAL and IFN- Ɣ, with other variables being less influential. The multivariate models exhibited AUCs of 0.85 (depression), 0.77 (anxiety) and 0.82 (both depression and anxiety).

Conclusions

The findings of this exploratory study provide potential models predicting depression and anxiety symptoms in SLE. This produces a basis for further research building a conceptual model explaining the mechanisms of these important patient-centered outcomes in SLE.

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.