| ObjectiveTo study the difference of GRM2 and GRM3 gene m RNA expression in blood samples between patients with insomnia disorder and normal subjects,and whether it can assist the diagnosis of insomnia disorder and further distinguish insomnia disorder with or without depressive symptoms.MethodsA total of 87 subjects were recruited in this study,51 of whom met the diagnostic criteria of Insomnia Disorder(ID)in DSM-5,and the remaining 36 subjects were Normal Controls(NC).All the subjects were assessed by the Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Patients Health Questionnaire-9 items(PHQ-9),Generalized Anxiety Disorder-7(GAD-7),Pittsburgh Sleep Quality Index(PSQI)and Insomnia Severity Index(ISI)and polysomnography(PSG)to evaluate their emotion and sleep characteristic.Real-time reverse transcription-polymerase chain reaction(RT-PCR)was used to estimate the GRM2 and GRM3 gene m RNA expression quantity of Group Ⅱ metabotropic glutamate receptor in their blood samples,and receiver operating characteristic(ROC)curves of them were also adopted to analyze the objective diagnostic value in insomnia disorder.Besides,the partial correlation analysis was conducted among the scales of mood and sleep,PSG data and the expression of GRM2,GRM3 gene m RNA in peripheral blood samples.SPSS 26.0 was used to process and analyze the recorded data.Results1.Compared with NC group,the scores of PSQI、ISI、HAMD、HAMA、PHQ-9 and GAD-7of the insomnia disorder group were higher(P<0.05),and the objective sleep data showed that sleep onset latency and the wakefulness after sleep onset were longer,the number of awakenings and the proportion of N1 sleep stage were larger,and both sleep efficiency and the proportion of REM sleep were smaller(P<0.05).2.Compared with NC group,GRM2 and GRM3 gene m RNA expression in blood samples were decreased in ID group(Z=-2.556,P=0.010;Z=-2.131,P=0.033).The area under the ROC Curve(AUC)were 0.719(95%CI: 0.557,0.880)and 0.682(95%CI: 0.521,0.842),respectively.The best truncation values were 7.905 and 24.605,respectively.And the AUC of GRM2 gene m RNA expression in blood samples was higher than 0.7,suggesting a good predictive value of insomnia disorder.3.The expression of GRM2 gene m RNA in blood samples of ID with mild depression(ID-D)group was lower than that in ID with no depressive symptoms(ID-N)group(Z=-2.472,P <0.05).The AUC was 0.721(95%CI: 0.557,0.884)> 0.7,indicating that the prediction value of ID with mild depression was good,and the optimal truncation value was 3.40.Besides,there was no significant difference in GRM3 gene m RNA expression in blood samples between the two subgroups.4.The expression of GRM2 gene m RNA in blood samples of patients with insomnia disorder was negatively correlated with PSQI scores(r=-0.263,P=0.048).Additionally,the expression of GRM3 gene m RNA in blood samples was positively related to total sleep time and sleep efficiency(r =0.329,P=0.036;r = 0.309,P = 0.049)and it showed negative correlation with scores of HAMD,ISI and PSQI(r=-0.368,P=0.005;r = 0.349,P = 0.008;r =-0.350,P=0.008).Conclusion1.GRM2 and GRM3 gene m RNA expression in blood samples can be used as biological markers of insomnia disorder,and the former had a higher value in assisting objective diagnosis of it.2.The lower expression of GRM2 gene m RNA in peripheral blood had predictive value for insomnia disorder with depressive symptoms.3.In blood samples of patients with insomnia disorder,the expression of GRM2 gene m RNA was correlated with PSQI scores,and the expression of GRM3 gene m RNA was associated with total sleep time,sleep efficiency,and the scores of HAMD,ISI and PSQI. |
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