The Level And Early Predictive Value Of Plasma SuPAR In Depressive Disorder In Adolescents Who Have Experienced Childhood Trauma

Objective:To investigate the significance of childhood trauma to Soluble Urokinase Plasminogen Activator Receptor（suPAR）in plasma of adolescents with depression disorder and to analyze the early predictive value of suPAR in adolescents with depressive disorder after childhood trauma.Methods:According to the diagnostic criteria of depressive disorder in DSM-5,a total of 117 adolescent patients with depressive disorder were included in the cross-sectional study.According to Childhood Trauma Questionnaire-short Form（CTQ-SF）,the patients were divided into the group who had experienced childhood trauma（n=88）and the group who had not experienced childhood trauma（n=29）.The Hamilton Depression Scale-17（HAMD-17）was used to assess the severity of depressive symptoms,the Adolescent Self-Rating Life Events Checklist（ASLEC）to assess recent life events,and the Child and Adolescent Social Support Scale（CASSS）to assess social support.Plasma suPAR levels and serum hypersensitive C-reactive protein（hs-CRP）levels were determined by double antibody sandwich enzyme-linked immunosorbent assay（ELSIA）.Plasma levels of 12 cytokines were determined by flow cytometry.Measurement data were expressed as mean±standard deviation or M(P₂₅,P₇₅).Comparison between groups was performed by the t test of two independent samples or the rank sum test.Count data were presented as example（%）,and comparison between groups was performed byχ² test.Spearman was used to analyze the correlation between suPAR and various indicators,and Receiver Operator Characteristic（ROC）curve was used to analyze the early predictive value of plasma suPAR in adolescent patients with depressive disorder who experienced childhood trauma.Results:The group who experienced childhood trauma accounted for 75.2%of the total.There were significant differences in parent-child relationship and mental symptoms between the group with and without childhood trauma（P<0.05）.Compared with the group without childhood trauma,the group with childhood trauma had higher HAMD-17 and ASLEC scores,lower CASSS scores（P<0.05）,the suPAR,IL-2,IL-4,IL-1βlevels are higher（P<0.05）.Spearman analysis showed that suPAR was positively correlated with CTQ-SF（r=0.211,P=0.023）,emotional abuse（r=0.223,P=0.016）,emotional neglect（r=0.218,P=0.018）,physical abuse（r=0.210,P=0.023）,HAMD-17（r=0.329,P=0.001）,ASLEC（r=0.251,P=0.006）,IL-2（r=0.288,P=0.002）,IL-4（r=0.195,P=0.035）,IL-1β（r=0.217,P=0.019）,and negatively correlated with CASSS（r=-0.200,P=0.031）.ROC curve analysis showed that the area under curve（AUC）for predicting depression in adolescents who experienced childhood trauma by plasma suPAR,IL-2,IL-4 and the IL-1βare 0.687,0.651,0.642 and 0.659,respectively.When the critical value of suPAR was4.74ng/ml,its sensitivity was 86.4%,but its specificity was 41.4%.Conclusions:1.The detection rate of childhood trauma in adolescents with depressive disorder is high.Patients who have experienced childhood trauma have poorer parent-child relationships,prominent psychiatric symptoms,more severe depressive symptoms,high responsiveness to stress,and less social support.2.Plasma levels of suPAR,IL-2,IL-4,and IL-1βare elevated in adolescents with depressive disorder who have experienced childhood trauma.suPAR is associated with emotional abuse,emotional neglect,physical abuse.3.Plasma suPAR is superior to IL-2,IL-4 and IL-1βin predicting the early value of adolescents with depressive disorder who have experienced childhood trauma.