Effect Of Different Depression Scales On The Correlation Between IL-6?TNF-? In Patients With COPD Complicated By Depression

Objective:Chronic obstructive pulmonary disease(COPD)is associated with cigarette smoke and other harmful particles inhalation-related systemic diseases,the early lesions confined to the lungs,and then may involve the body,including systemic inflammation and depression.Each year COPD resulting in about 100 million people died,more than 5 million people disabled,is the disease ranked first in burden of China disease.And depression is expected to become the world's second-largest public health problem by 2020,although the diagnosis and treatment of depression is still inadequate,especially in patients with COPD.The presence of both diseases can interact with each other and increase the risk of poor prognosis.At present,the mechanism of disease in patients with COPD is not clear,as one of the hypothesis of inflammation mechanism is still controversial.Study shows that different depression scale will affect some of the characteristics of the study(such as:gender prevalence),then is it due to the use of different Depression Scales lead to the controversy of the relationship between depression and inflammatory factors,in stable COPD patients?Inflammatory factors such as interleukin-6(IL-6)and tumor necrosis factor-?(TNF-?)may play a role in the pathogenesis of COPD and depression.Therefore,this study selected stable COPD patients,using three different depression scales to diagnose depression,to explore whether the different depression scales affect the correlation between depression and inflammatory factors IL-6,TNF-? in stable COPD patients.Methods:Follow up eligible stable COPD patients ever treated in the Affiliated Hospital of Southwest Medical University?QianCao and ShiDong community in LuZhou City were assessed with the Center for Epidemiological Studies Depression Scale(CES-D)?Geriatric depression scale(GDS)and Hamilton Depression Scale-24(HAMD-24),finish basic information table;measurement of height,weight,lung function;CAT score,mMRC score and other projects.Timely order information and complete the entry,remove the subject whose information is incomplete.Serum IL-6 and TNF-a levels were measured by enzyme-linked immunosorbent assay(ELISA).The differences of IL-6 and TNF-a levels between the depression group and the non-depression group were compared in different depression scale.Results:1.CES-D,GDS and HAMD-24 scale in 40 patients with stable COPD showed similar prevalence rates of depression in 30%(12 cases),27.5%(11%))And 20%(8 cases),the difference was not statistically significant(P = 0.57).2.Use HAMD-24 as the diagnostic criteria for depression,make ROC curves of CES-D and GDS scale,CES-D scale was more sensitive(AUC = 0.90),compared with the GDS scale,but no statistically significant was found(P = 0.80).3.The score of CAT in the CES-D scale were statistically significant between the depression group and the non-depression group(P<0.05),but not in the GDS and HAMD-24 scale.The grade of GOLD in the HAMD-24 scale were statistically significant between the depression group and the non-depression group(P<0.05),but not in the CES-D and GDS scale.4.There was no statistically significant difference of the inflammatory factors IL-6,TNF-? between depression and non-depression patients in the three different depression scales(P<0.05).However,it shows a.weak negative correlation between the HAMD-24 score and the inflammatory factors IL-6,TNF-?(P<0.05),but not in the CES-D and GDS scale.Conclusion:1.Different depression scales(CES-D,GDS and HAMD-24)did not affect the prevalence of depression in stable COPD patients,and the relationship between inflammatory factors IL-6,TNF-a and depression.2.The diagnosis of depression in different depression scales can affect certain characteristics of stable COPD combined with depression,such as the CAT score,GOLD classification and the correlation of depression score with inflammatory factors IL-6,TNF-a.3.Perhaps,clinically,we should target at COPD patients with high CAT score,high level of GOLD classification,to finish depression scale assessment,if necessary,combined with the diagnosis of mental specialist to confirm the diagnosis of depression in-COPD patient,and improve the prognosis.