Telomere Length In Peripheral Blood Of Depressive Patients And Its Changes Before And After Electroshock Antidepressant Treatment

Objective:By comparing the telomere length of peripheral blood between the patients with Major Depressive Disorder(MDD)and the healthy control group,we preliminarily explored some causes of depression at the molecular level.By observing the changes of telomere length in peripheral blood of depressive patients before and after modified electroconvulsive therapy(MECT),we explored the relationship between telomere length and efficacy of MECT antidepressant therapy.Methods:Sixty patients who were hospitalized in the Jining Psychiatric Hospital from October 2017 to October 2018 and were diagnosed with major depression and received MECT were selected as the study subjects.At the same time,50 healthy volunteers of the same age were selected as the control group.We collected the clinical data of observation group at baseline and 1month after MECT treatment,including HAMD,HAMA,SSI scale,and so on.One month after MECT treatment,according to the reduction rate of Hamilton Depression Scale,patients were divided into effective group(HAMD reduction rate?50%)and ineffective group(HAMD reduction rate < 50%).The telomere length of peripheral blood of the above subjects was detected by real-time quantitative polymerase chain reaction(RT-qPCR).By comparing difference of telomere level between the observation group and the normal control group and the observation group before and after electroconvulsivetherapy,examining the clinical data and the difference in telomere length before and after treatment in the different treatment groups,we explored the risk factors and efficacy indicators of depression.Results:1.A total of 60 patients with major depression and 50 healthy controls were included in the study.The telomere length at baseline and after treatment were lower in the depression group than in the normal control group(p<0.05).The results of subgroup analysis showed that the baseline telomere length of male and female depressive patients was less than that of the control group(P <0.05).2.Telomere length was negatively correlated with age in normal control group(r=-0.935,P=0.000),and there was no gender difference in telomere length(P=0.939).Depression patients were grouped according to gender,incentives,positive family history,suicide concept,psychiatric symptoms or anxiety symptoms,there was no difference in telomere length,P > 0.05.There was no significant correlation between telomere length and course of disease,age,HAMD scale score,HAMA scale score in depressive patients,P > 0.05.3.The median of the telomere length in the normal group was used as the cut-off point.The subjects were divided into short telomere group and long telomere group.After adjusting for age and gender factors,the risk of disease in the short telomere group was 10.21 times that of the long telomere group.After that,we studied the risk of depression in the short telomere group as 17.24 times as high as that in the long telomere group(P = 0.000),and in the middle telomere group as 3.69 times as high as that in the long telomere group(P =0.048),and there was a significant dose-dependent relationship between the risk of depression and telomere length(OR=0.08,P=0.000).4.The scores of HAMD,HAMA and SSI in depressive patients after MECT treatment were lower than those before treatment,and the difference was significant(P < 0.05).There was no significant difference in telomere length before and after MECT treatment,P=0.378.5.At the end of MECT treatment,according to the reduction rate of HAMD scale,the patients were divided into two groups,35 in the effective group and25 in the ineffective group.The results of paired t test showed that after treatment,telomere length in the effective group increased(P=0.003),while the telomere length in the ineffective group was shorter than that in the baseline group(P=0.011),and the difference was significant.Conclusions:1.Telomere shortening may be an important molecular mechanism for the occurrence and development of depression.2.Telomeres may be a new marker reflecting the efficacy of MECT antidepressant therapy.MECT antidepressant therapy should be able to restore telomere length.