Epidemiological Investigation And Genetic Study Of Mood Disorder Related To Menopause

Objective: Through investigating mood disorder and the influence of related gene polymorphism on mood disorders about middle-aged women in Shanghai,to explore the management strategies of mood disorders in perimenopausal and postmenopausal women.Methods: A cross-sectional study of 2014 women aged 40-60 years old from the Health Examination Center of Shanghai Jiao Tong University Affiliated Sixth People's Hospital?Health Examination Center of Shanghai Sixth People's Hospital East Branch and Health Examination Center of International Peace Maternal and Child Health Hospital of the China Welfare Institute.Using the questionnaire survey to obtain the basic information of the subjects and Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS),Modified Kupperman Index(KMI),The Pittsburgh Sleep Quality Index(PSQI)were also measured by questionnaire.SPSS 20.0 software was used to analyze the data.On the basis of sample 1,a logistic regression model was established.Then using the beta coefficient to calculate and predict the risk of depressive symptoms and anxiety symptoms in menopausal women,a scoring system was established.The scoring system was validated in two other centers.458 perimenopausal or postmenopausal women who selected from sample 1 were divided into symptomatic and no symptomatic groups according to SAS and SDS scores.18 SNPs of MAO-A,TPH1,TPH2 and 5-HTR2 A were detected by SNaPshot method.Hardy-Wenberg test was performed.Then we analyze the relationship between anxiety symptoms and depressive symptoms and gene polymorphism.Results: Among the 2014 women enrolled in the study,the prevalence of anxiety and depressive symptoms was 9.0% and 12.2%.Their risk factors associated with menopause status,education,history of diabetes,history of cancer,history of breast cancer or family history and so on.Risk scoring system of anxiety symptom has a total score of 0-64 points and an optimal cut-off point is 29 points.The area under the ROC curves for samples 1,2 and 3 are 0.805,0.812,0.811,respectively.The sensitivity of samples 1,2 and 3 were 0.771,0.929 and 0.884,respectively,and the Youden index was 0.490;The total score of the risk score system for depressive symptom is 0-54 and the optimal cut-off point is 25 points.The area under the ROC curve for samples 1,2 and 3 is 0.729,0.720,0.739.The sensitivity of samples 1,2 and 3 is 0.713,0.815 and 0.854,respectively,and the Youden index is 0.311.In the genetic analysis,the rs2235186 of the MAO-A gene did not meet the HWE balance(P <0.05),and the other genotype were in line with the HWE balance(P> 0.05).The rs4570625 of TPH2 gene and rs9326236 of 5-HTR2 A gene were statistically different between the anxiety symptom group and no anxiety group(p = 0.045,p = 0.010).The rs6311 and rs6313 of 5-HTR2 A gene were statistically different between depressive symptom group and no depressive group(p = 0.014).Conclusion: The prevalence of depression and anxiety is higher in perimenopausal and postmenopausal women.Symptoms are associated with menopausal status,the score of hot flashes sweating times and chronic diseases.Anxiety symptoms may be related to rs4570625 of TPH2 gene and rs9326236 of 5-HTR2 A gene.Depression symptoms may be related to rs6311 and rs6313 of 5-HTR2 A gene.