Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2023; 13(9): 665-674
Published online Sep 19, 2023. doi: 10.5498/wjp.v13.i9.665
Immune function, gastrointestinal hormone levels, and their clinical significance in patients with gastric ulcers complicated with depression
Yun-Han Yang, De-Jun Cui, Zai-Li Yang, Wen-Qiang Yuan, Bo Huang
Yun-Han Yang, De-Jun Cui, Zai-Li Yang, Wen-Qiang Yuan, Bo Huang, Department of Gastroenterology, Guizhou Inflammatory Bowel Disease Research Center, National Institution of Drug Clinical Trial, Guizhou Provincial People’s Hospital, Medical College of Guizhou University, Guiyang 550002, Guizhou Province, China
Author contributions: Yang YH and Cui DJ co-designed the study, wrote the paper, contributed equally to this work, and are the first co-authors; Yang ZL, Yuan WQ, and Huang B participated in the study and provided clinical recommendations.
Supported by the Cultivation Fund of National Natural Science Foundation, No. qiankehe2018-5764-11.
Institutional review board statement: The study was reviewed and approved by Guizhou Provincial People’s Hospital (2023-041).
Informed consent statement: Written informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: According to institutional policies, third-party access to data is not supported.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Han Yang, MM, Attending Doctor, Department of Gastroenterology, Guizhou Inflammatory Bowel Disease Research Center, National Institution of Drug Clinical Trial, Guizhou Provincial People’s Hospital, Medical College of Guizhou University, No. 83 East Zhongshan Road, Guiyang 550002, Guizhou Province, China. yunhan_y@163.com
Received: July 18, 2023
Peer-review started: July 18, 2023
First decision: August 4, 2023
Revised: August 16, 2023
Accepted: August 25, 2023
Article in press: August 25, 2023
Published online: September 19, 2023
Abstract
BACKGROUND

Gastric ulcer (GU) is a common digestive tract disease, and medical records of GU combined with depression are increasingly common. Currently, the risk factors and pathogenesis of GU complicated with depression remain unclear. Low immune function and gastrointestinal hormone levels may also be significant risk factors. Therefore, this study explored the immune function and gastrointestinal hormone levels in patients with GU combined with depression.

AIM

To explore the immune function, gastrointestinal hormone level, and clinical significance of patients with GU combined with depression.

METHODS

A retrospective analysis was conducted on 300 patients with GU combined with depression admitted to Guizhou Provincial People’s Hospital from January 2021 to June 2022 as the study subjects. According to the Hamilton Depression Scale (HAMD) score, patients were divided into mild-to-moderate (n = 210) and heavy (n = 90) groups. Basic data, immune function indices [immunoglobulin A (IgA), IgM, IgG, serum CD4+ and CD8+ percentage, and CD4+/CD8+ ratio], and gastrointestinal hormone indices [serum gastrin (GAS), cholecystokinin (CCK), and motilin (MTL) levels] were collected. The basic data of the two groups were compared, and the immune function and gastrointestinal hormone indices were analyzed. Multivariate logistic regression was used to analyze the factors influencing the severity of GU complicated with depression. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to analyze the value of the immune function index, gastrointestinal hormone index, and combined index in predicting the severity of GU complicated with depression.

RESULTS

There were no marked differences in sex, age, body mass index, abdominal distension, abdominal pain, belching, nausea, vomiting, or sleep disorders between the heavy and mild-to-moderate groups (P > 0.05). There was a marked difference in the family history of depression between the heavy and mild-to-moderate groups (P < 0.05). There were significant differences in serum IgA and IgM levels and serum CD4+, CD8+, and CD4+/CD8+ ratios between the heavy and mild-to-moderate groups (P < 0.05). Multivariate analysis showed that IgA, IgM, GAS, and CCK serum levels influenced the severity of GU with depression (P < 0.05). The AUC of the ROC curve for serum IgA level predicting GU with depression severity was 0.808 [95% confidence interval (CI): 0.760-0.857], the AUC of the serum IgM level was 0.757 (95%CI: 0.700-0.814), the AUC of the serum GAS level was 0.853 (95%CI: 0.810-0.897), the AUC of the serum CCK level was 0.762 (95%CI: 0.709-0.822), the AUC of immune function (IgA, IgM) and gastrointestinal hormone levels (GAS, CCK) for the prediction of GU with depression severity was 0.958 (95%CI: 0.933-0.976).

CONCLUSION

Important factors influencing GU complicated with depression are serum IgA, IgM, GAS, and CCK indicators. They can be used as indicators to predict the severity of GU complicated with depression.

Keywords: Gastric ulcer combined with depression, Immune function, Gastrointestinal hormones

Core Tip: The occurrence and severity of gastric ulcer (GU) combined with depression may be related to autoimmune dysfunction and gastrointestinal hormone levels. In this study, multivariate logistic regression analysis was used to influence the severity of concurrent depression in GU. The results suggest that impaired T cell function and gastrointestinal hormone disorders may directly affect the development and development of depression. In addition, the immune function indicators combined with gastrointestinal hormone levels predict high AUC, specificity and sensitivity, which has a very good reference value.