Relationship between sleep and serum inflammatory factors in patients with major depressive disorder

Association between serum alpha-1-acid glycoprotein (AGP) levels and depression: The mediation effect of triglyceride-glucose (TyG) index

Alpha-1-acid glycoprotein (AGP) is regarded as an inflammatory factor. Currently, the relationship between serum AGP levels and depression is controversial. We designed a cross-sectional study to explore the association between serum AGP levels and depression using data from the National Health and Nutrition Examination Survey (NHANES) from 2021 to 2023. The PHQ-9 questionnaire was used to investigate the depression symptoms of participants, and the PHQ-9 score ≥ 10 was regarded as depression. Weighted multivariate logistic regression models, weighted multiple linear models, restricted cubic splines models (RCS), subgroup analyses, and interaction tests were performed to explore the association of serum AGP levels with depression. ROC curves were used to plot the predictive effect of AGP on depression. The mediation analysis was conducted to assess the mediation effect of the TyG index. Our study revealed that serum AGP levels were positively and linearly associated with depression. In the fully adjusted model, the odds ratio of depression elevated by 1.04 times (OR = 2.04, 95 % CI: 1.17-3.57), and the PHQ-9 score increased by 1.47 (β = 1.47, 95 % CI: 0.37-2.56) for each ln-unit AGP level increase, respectively. A positive relationship was also observed in some subgroups. Furthermore, AGP presented a strong predictive effect on depression. In addition, the TyG index had a significant mediation effect on the relationship between serum AGP levels and depression. In general, our study provides some new insight into the role of AGP on depression and the mediation effect of the TyG index.

Association between the serum alpha-1-acid glycoprotein concentrations and depression in US adult women: a cross-sectional study

BACKGROUND

Emerging evidence has demonstrated a positive association of inflammation with depression. As an acute-phase reactant predominantly synthesized in hepatocytes, alpha-1-acid glycoprotein (AGP) serves as a sensitive biomarker of inflammation. However, there is a limited study to explore the relationship between AGP and depression. Currently, the association of AGP with depression is controversial.

METHODS

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2021 and 2023. The Patient Health Questionnaire-9 (PHQ-9) was employed to assess depressive symptoms, with a score ≥ 10 indicating clinically relevant depression. We utilized weighted multivariate logistic regression for depression outcomes, weighted linear regression for continuous PHQ-9 scores, and restricted cubic splines (RCS) to examine potential nonlinear relationships between AGP and depression. To evaluate the robustness of these associations, we conducted comprehensive subgroup analyses with interaction tests and multiple sensitivity analyses.

RESULTS

Serum AGP concentrations exhibited a significant positive association with depression among U.S. adult women, demonstrating a linear dose-response relationship. In the fully adjusted model, each ln-unit increase in AGP concentrations was associated with a 1.13-fold higher odds ratio of depression (OR: 2.13, 95% CI: 1.26-3.64) and a 1.47-point elevation in PHQ-9 values (β: 1.47, 95% CI: 0.37-2.56). Moreover, participants in the highest AGP quartile had a 0.72-fold increased odds ratio of depression (OR: 1.72, 95% CI: 1.03-2.87) and a 1.32-point higher PHQ-9 score (β:1.32, 95% CI: 0.31-2.34) compared to those in the lowest quartile. This positive association remained consistent across multiple subgroup analyses.

CONCLUSIONS

Serum AGP concentrations demonstrated a significant positive linear association with depressive symptoms among nationally representative samples of U.S. adult women.

The relationship between multiple chronic diseases and sleep quality among the older people ≥ 60 years in China

BACKGROUND

High-quality sleep is essential for both physical well-being and mental health, particularly in promoting the health and longevity of older adults. However, limited evidence exists regarding the relationship between chronic diseases and sleep quality in this population.

METHODS

The study investigated 35 common chronic diseases among 1186 older individuals aged 60 and above from six rural communities in northwest China. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multiple logistic regression and interaction analyses were employed to explore the relationship between multiple chronic diseases and sleep quality.

RESULTS

Compared with the first quartile (≤ 1) of the number of chronic diseases, the second (2), third (3-4), and fourth (≥ 5) quartile ORs were 1.771 (95% CI: 1.191-2.631, p = 0.005), 2.434 (95% CI: 1.660-3.567, p < 0.001), and 3.180 (95% CI: 2.039-4.959, p < 0.001), respectively. For the duration of chronic diseases, compared with the first quartile (≤ 4.32 years) of duration of chronic diseases, the second (4.33-7.49 years), third (7.50-11.32 years) and fourth (≥ 11.33 years) quartile ORs were 1.350 (95% CI: 0.931-1.957, p = 0.113), 1.381 (95% CI: 0.953-2.000, p = 0.088), and 1.629 (95% CI: 1.122-2.365, p = 0.010), respectively. Older adults with multimorbidity and a longer duration of chronic diseases (≥ 7.5 years) had poorer sleep quality than those without multimorbidity and shorter duration of chronic diseases.

CONCLUSION

The higher number and longer duration of chronic diseases are associated with poorer sleep quality among older adults, with a stronger correlation observed in females compared to males.

Plasma IL-1β Concentration Associates with Sleep Quality and Cognitive Functions in Men with Prostate Cancer

OBJECTIVES

The purpose of this study was to ascertain whether sleep quality is altered in patients with prostate cancer (PCa) during androgen deprivation therapy (ADT) and whether sleep impairment associates with depressive symptoms, cognitive function or frailty syndrome, and if this varies between patients with localized or metastatic disease. The pro-inflammatory cytokine, IL-1β is involved in sleep regulation, we assessed whether sleep quality, depressive symptoms, cognitive function or frailty syndrome are associated with IL-1β concentration.

METHODS

Sleep quality was assessed using the Athens Insomnia Scale (AIS), depressive symptoms using the Yesavage Scale (GDS), and cognitive functions using the MiniMental State Exam (MMSE) and the level of frailty was measured based on the Fried criteria. Plasma IL-1β was measured by enzyme-linked immunoassay. Linear regression lanalyses were performed to determine which variables predict plasma IL-1β is involved in poor sleep quality and higher IL-1β concentration.

RESULTS

A cross-sectional study was carried out between 2021 and 2023. Sixty-seven men with PCa (N=36 (53.7%) with localized disease and N=31 (46.3%) with metastatic disease) were enrolled in the study. Plasma IL-1β concentration correlated with poorer sleep quality in all sample and, men with metastatic PCa had poorer sleep quality compared to men with localized disease. Analysis of self-reported sleep quality revealed that half of them had insomnia symptoms and 19.4% reported clinically relevant insomnia disorder (mean value of AIS 3.39±0.44). Poor sleep quality significantly predicted the concentration of IL-1β in plasma. In contrast, a better cognitive function significantly (P = .037) predicted IL-1β concentration. Detailed analysis of AIS items showed that score in the item "Sleep induction" and "Sleepiness during the da) significantly predicted IL-1β concentrations (P = .001 and P0=.044, respectively).

CONCLUSIONS

Plasma IL-1β levels may be useful to address the presence of insomnia in patients with PCa who are receiving ADT and to monitor the effect of interventions to improve sleep problems in these patients.

IMPLICATIONS FOR NURSING PRACTICE

Nurses will play a critical role in educating patients about their risk for specific symptoms based on an evaluation of specific biomarkers such as IL-1β and sleep quality. Nurses will be involved in using biomarker data to titrate medications and to evaluate the effect of nonpharmacological interventions to improve sleep quality in patients with PCa.

Association between sleep quality and serum biomarkers among long-term hot spring bathers: a cross-sectional study

Previous studies investigating the influence of hot spring bathing on sleep quality have predominantly focused on the short-term effects through questionnaire surveys without blood collection for biochemical tests. Here, we undertook a comprehensive investigation of the long-term health effects of hot spring bathing among the residents of Hot Spring Village. A total of 140 participants were enrolled, and their demographic characteristics and the patterns of hot spring bathing were obtained via face-to-face interview, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Moreover, the blood samples of the participants were collected for biomarker detection with the ELISA assay. Logistic regression analysis was applied to evaluate the relationship between sleep quality and serum biomarkers among long-term hot spring bathers. In individuals aged 65 and older, the results demonstrated that hot spring bathing (OR = 0.18, 95%CI: 0.05-0.68), particularly with a length of ≥ 30 min (OR = 0.10, 95%CI: 0.02-0.53) and a frequency of ≥ 3 times/week (OR = 0.07, 95%CI: 0.01-0.32) were significant protective factors for good sleep quality (P < 0.05). Furthermore, reduced TNF-α (OR = 1.03, 95% CI: 1.01-1.06) and increased 5-HT levels (OR = 0.98, 95% CI: 0.97-0.99) were associated with good sleep quality. Interestingly, for the first time, we observed that the TNF-α significantly decreased (P < 0.05) in the bathing group, along with an increasing trend of 5-HT and BDNF. Moreover, among participants in this group who reported good sleep quality, there was a notably significant decrease in TNF-α and an increase in 5-HT levels as well. These findings suggested that long-term hot spring bathing is associated with good sleep quality through the alteration of TNF-α and 5-HT levels, which could be potential biomarkers for future investigation on the health-promoting effects of bathing.

Exogenous L-fucose attenuates depression induced by chronic unpredictable stress: Implicating core fucosylation has an antidepressant potential

Core fucosylation is one of the most essential modifications of the N-glycans, catalyzed by α1,6-fucosyltransferase (Fut8), which transfers fucose from guanosine 5'-diphosphate (GDP)-fucose to the innermost N-acetylglucosamine residue of N-glycans in an α1-6 linkage. Our previous studies demonstrated that lipopolysaccharide (LPS) can induce a more robust neuroinflammatory response in Fut8 homozygous knockout (KO) (Fut8-/-) and heterozygous KO (Fut8+/-) mice contrasted to the wild-type (Fut8+/+) mice. Exogenous administration of L-fucose suppressed LPS-induced neuroinflammation. Numerous studies indicate that neuroinflammation plays a vital role in the development of depression. Here, we investigated whether core fucosylation regulates depression induced by chronic unpredictable stress (CUS), a well-established model for depression. Our results showed that Fut8+/- mice exhibited depressive-like behaviors and increased neuroinflammation earlier than Fut8+/+ mice. Administration of L-fucose significantly reduced CUS-induced depressive-like behaviors and pro-inflammatory cytokine levels in Fut8+/- mice. The L-fucose treatment produced antidepressant effects by attenuating the complex formation between gp130 and the interleukin-6 (IL-6) receptor and the JAK2/STAT3 signaling pathway. Notably, L-fucose treatment increased dendritic spine density and postsynaptic density protein 95 (PSD-95) expression, which were suppressed in CUS-induced depression. Furthermore, the effects of L-fucose on the CUS-induced depression were also observed in Fut8+/+ mice. Our results clearly demonstrate that L-fucose ameliorates neuroinflammation and synaptic defects in CUS-induced depression, implicating that core fucosylation has significant anti-neuroinflammatory activity and an antidepressant potential.

Understanding the connection between stress and sleep: From underlying mechanisms to therapeutic solutions

The objective of this chapter is to navigate through the nexus between stress and sleep, highlighting the neurobiological systems that connect them. Starting with an overview of neuroanatomy and physiology of stress and sleep, with a further detailed breakdown of sleep stages and key neuroanatomical centers that are responsible for sleep and wakefulness. Starting with suprachiasmatic nuclei (SCN) in circadian rhythm and sleep regulation overview, with a center point on the molecular systems including the CLOCK/CRY and BMAL1/2/PER1/2 feedback loops. Following this is the neurobiological of stress, specifically the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal (SPA) axis and influence on sleep. Vital neural circuits connecting stress and sleep are examined with the attention of the ventral tegmental area (VTA) GABA-somatostatin neurons and the locus coerules in sleep regulation in response to stress. In addition, neuroinflammation's role occurs through the cytokines IL-1β and TNF-α are investigated as a mediator of sleep disturbances caused by stress. It concludes by summarizing the implications of neuroinflammatory modulation in stress-related psychopathologies, emphasizing the opening this provides for interventions that target this inflammation helping to lighten sleep disorder.

Exploring shared biomarkers and shared pathways in insomnia and atherosclerosis using integrated bioinformatics analysis

Background

Insomnia (ISM) is one of the non-traditional drivers of atherosclerosis (AS) and an important risk factor for AS-related cardiovascular disease. Our study aimed to explore the shared pathways and diagnostic biomarkers of ISM-related AS using integrated bioinformatics analysis.

Methods

We download the datasets from the Gene Expression Omnibus database and the GeneCards database. Weighted gene co-expression network analysis and gene differential expression analysis were applied to screen the AS-related gene set. The shared genes of ISM and AS were obtained by intersecting with ISM-related genes. Subsequently, candidate diagnostic biomarkers were identified by constructing protein-protein interaction networks and machine learning algorithms, and a nomogram was constructed. Moreover, to explore potential mechanisms, a comprehensive analysis of shared genes was carried out, including enrichment analysis, protein interactions, immune cell infiltration, and single-cell sequencing analysis.

Results

We successfully screened 61 genes shared by ISM and AS, of which 3 genes (IL10RA, CCR1, and SPI1) were identified as diagnostic biomarkers. A nomogram with excellent predictive value was constructed (the area under curve of the model constructed by the biomarkers was 0.931, and the validation set was 0.745). In addition, the shared genes were mainly enriched in immune and inflammatory response regulation pathways. The biomarkers were associated with a variety of immune cells, especially myeloid immune cells.

Conclusion

We constructed a diagnostic nomogram based on IL10RA, CCR1, and SPI1 and explored the inflammatory-immune mechanisms, which indicated new insights for early diagnosis and treatment of ISM-related AS.

Acute hyper-hypoxia accelerates the development of depression in mice via the IL-6/PGC1α/MFN2 signaling pathway

Background

Neural cell damage is an important cause of exacerbation of depression symptoms caused by hypoxia, but the mechanism behind it is still unclear. The purpose of this study is to elucidate the role of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α)/mitofusin-2 (MFN2) signaling axis in the development of depression in mice under hypoxia.

Methods

Male Institute of Cancer Research mice (age, 6 weeks) were assigned to the normal group, chronic unpredictable mild stress group (CUMS group), or CUMS + hyper-hypoxia group (CUMS + H group). Mice in the CUMS and CUMS + H groups were exposed to CUMS for 28 days. Additionally, mice in the CUMS + H group were exposed to acute hyper-hypoxia from Day 21 for 7 days. After a total of 28 days, behavioral experiments were conducted. All mice were anesthetized and sacrificed. Levels of brain tissue interleukin (IL)-6, reactive oxygen species (ROS), adenosine triphosphate (ATP), and serotonin (5-HT) were analyzed.

Results

As compared to the CUMS group, mice in the CUMS + H group had increased IL-6 and ROS levels, but lower open-field activity, preference for sucrose, hippocampal neuronal membrane potential, ATP, and 5-HT levels, as well as MFN2 and PGC1α levels.

Conclusions

Acute hyper-hypoxia plays an important role in the development of depression via the IL-6/PGC1α/MFN2 signaling pathway.

Causality between sleep traits and the risk of frailty: a Mendelian randomization study

Background

Research based on observation has demonstrated a relationship between sleep traits and frailty; however, it remains uncertain if this correlation indicates causation. The purpose of this study was to look at the causal relationship that exists between frailty and sleep traits.

Method

Using summaries from a genome-wide association study of self-reported sleep features and frailty index, we performed a bidirectional Mendelian randomization (MR) analysis. Examining the causal relationships between seven sleep-related traits and frailty was the goal. The major method used to calculate effect estimates was the inverse-variance weighted method, supplemented by the weighted median and MR-Egger approaches. The study investigated pleiotropy and heterogeneity using several methodologies, such as the MR-Egger intercept, the MR-PRESSO approach, and the Cochran's Q test. We took multivariate Mendelian randomization and genetic correlations between related traits to enhance the confidence of the results. Furthermore, we used MRlap to correct for any estimation bias due to sample overlap.

Results

Insomnia, napping during the day, and sleep apnea syndrome exhibited a positive connection with the frailty index in forward MR analysis. Conversely, there is a negative link between getting up in the morning, snoring and sleep duration with the frailty index. During the reverse MR analysis, the frailty index exhibited a positive correlation with insomnia, napping during the day, and sleep apnea syndrome, while demonstrating a negative correlation with sleep duration. There was no direct correlation between snoring, chronotype, and frailty. In MVMR analyses, the causal effect of sleep characteristics on frailty indices remained consistent after adjusting for potential confounders including BMI, smoking, and triglycerides.

Conclusion

The findings of our investigation yield novel evidence that substantiates the notion of a bidirectional causal connection between sleep traits and frailty. Through the optimization of sleep, it is potentially feasible to hinder, postpone, or even reverse the state of frailty, and we proposed relevant interventions.

Potential antidepressant effects of Traditional Chinese botanical drug formula Chaihu-Shugan-San and its active ingredients

Background: Depression is a severe mental disorder that poses a significant threat to both the physical and mental wellbeing of individuals. Currently, there are various methods for treating depression, including traditional Chinese herbal formulations like Chaihu-Shugan-San (CSS), which have shown effective antidepressant effects in both clinical and animal research. Objective: This review aims to provide a comprehensive synthesis of evidence related to CSS, considering both preclinical and clinical studies, to uncover its potential multi-level, multi-pathway, and multi-target mechanisms for treating depression and identify its active ingredients. Methods: A thorough search was conducted in electronic databases, including PubMed, MEDLINE, Web of Science, Google Scholar, CNKI, and Wanfang, using keywords such as "Chaihu Shugan" and "depression" to retrieve relevant literature on CSS and its active ingredients. The review process adhered to the PRISMA guidelines. Results: This review consolidates the mechanisms underlying antidepressant effects of CSS and its active ingredients. It emphasizes its involvement in the regulation of monoaminergic neurotransmitter systems, synaptic plasticity, and the hypothalamic-pituitary-adrenal axis, among other aspects. Conclusion: CSS exerts a pivotal role in treating depression through various pathways, including the monoaminergic neurotransmitter system, the hypothalamic-pituitary-adrenal axis, synaptic plasticity, inflammation, brain-derived neurotrophic factor levels, and the brain-gut axis. This review facilitates a comprehensive understanding of the current state of CSS research, fostering an in-depth exploration of the etiological mechanisms of depression and the potential discovery of novel antidepressant drugs.