Serum Levels of Zinc, Albumin, Interleukin-6 and CRP in Patients with Unipolar and Bipolar Depression: Cross Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Procedures
2.2. Collection of Blood Samples
2.3. Statistical Analysis
2.4. Determination of CRP, Zinc, and Albumin
2.5. Determination of IL-6
2.6. Performing an ELISA Test
3. Results
3.1. Sociodemographic and General Medical Characteristics of Study Participants
3.2. Serum Levels of Il-6, CRP, Alb and Zn in Patients and Healthy Control Subjects
3.3. Comparison of Serum Levels of Il-6, CRP, Alb, and Zn in Patients with Depressive Episode of Bipolar Disorder (DBD), Unipolar Depression (UD), and Healthy Control Group (HC)
3.4. Comparison of Serum Levels of Il-6, CRP, Albumin, and Zinc in BD and UD Subjects
3.5. Association between Serum Levels of IL-6, Zn, Alb, CRP, and Severity of Depressive Episode According to HAMD-17 and MADRS
3.6. Correlations of Zn, Alb, CRP, and IL-6, with Items on the HAMD-17 and MADRS
3.7. The Influence of Sociodemographic Data, General Medical Conditions and Substance Abuse Including Tobacco Smoking on the Severity of Depressive Episode According to HAMD and MADRS (Logistic Regression)
4. Discussion
4.1. Comparison of Serum Levels of Zinc, Albumin, IL-6, and CRP between the Group of Depressive Subjects (UD and BDD) and Healthy Controls (HC)
4.2. Comparison of Serum Levels of Zinc, Albumin, IL-6, and CRP between the Groups of Unipolar Depressive Subjects (UD), Bipolar Depressive Subjects (BDD), and Healthy Controls (HC)
4.3. Comparison of Serum Levels of Zinc, Albumin, IL-6, and CRP between the Groups of Unipolar Depressive Subjects (UD) and Bipolar Depressive Subjects (BDD)
4.4. Comparison of the Results on Depression Rating Scales (HAMD-17 and MADRS) between the Examined Groups of Depressive Patients (UD and BD)
4.5. Comparison of the Results of the Examined Groups of Depressive Patients (UD and BD) on the HAMD-17 and MADRS Rating Scales for Depression with Respect to the Severity of the Depressive Episode
4.6. Correlations of the Examined Parameters (Zn, Albumin, IL-6, and CRP) in Both Groups of Depressive Subjects (UD and BD) with Items on the Depression Rating Scales (HAMD-17 and MADRS)
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Healthy Control (HC) | Patient Groups | Total | p * | |
---|---|---|---|---|
Gender [n (%)] | ||||
Female | 60 (75) | 84 (64.1) | 144 (68.2) | 0.10 |
Male | 20 (25) | 47 (35.9) | 67 (31.8) | |
Age (years) [Median (IQR)] | 53 (44–57) | 55 (47–58) | 54 (42–57) | 0.06 † |
Percentage of Participants (%) | p * | |||
---|---|---|---|---|
Unipolar Depression | Bipolar Depression | Total | ||
Educational Level | ||||
No formal education | 1 (2) | 1 (2) | 2 (2) | 0.004 |
Elementary school | 10 (15) | 9 (14) | 19 (15) | |
High school | 44 (67) | 31 (47) | 75 (56) | |
College (short program) | 9 (14) | 9 (13) | 18 (14) | |
University degree | 1 (2) | 16 (24) | 17 (13) | |
Employment Status | ||||
Employed | 27 (42) | 32 (48) | 59 (45) | 0.633 |
Unemployed | 18 (28) | 14 (21) | 32 (24) | |
Retired | 20 (30) | 20 (31) | 40 (31) | |
Marital Status | ||||
Married | 41 (64) | 37 (55) | 78 (60) | 0.418 † |
Divorced | 9 (15) | 13 (20) | 22 (17) | |
Single | 10 (15) | 14 (22) | 24 (18) | |
Widowed | 5 (7.6) | 2 (3) | 7 (5) | |
Psychiatric Heredity | 18 (28) | 24 (36) | 42 (32) | 0.288 |
Family History of Psychiatric Illness (n = 40) | ||||
Mother—depressive disorder | 6 (33.3) | 12 (54.5) | 18 (45) | 0.498 † |
Father—depression | 1 (5.6) | 1 (4.5) | 2 (5) | |
Father—alcoholism, suicide | 1 (5.6) | 0 | 1 (3) | |
Father—alcoholism | 4 (22) | 5 (22.7) | 9 (23) | |
Mother—bipolar disorder | 0 | 2 (9.1) | 2 (5) | |
Sister—depression | 1 (5.6) | 1 (4.5) | 2 (5) | |
Sister—schizophrenia | 1 (5.6) | 0 | 1 (3) | |
Father—suicide | 1 (5.6) | 0 | 1 (3) | |
Sister and mother suicide, father alcoholic | 1 (5.6) | 0 | 1 (3) | |
Brother PTSD, brother alcoholism, mother BAP | 0 | 1 (4.5) | 1 (3) | |
Father and brother depression and suicide | 1 (5.6) | 0 | 1 (3) | |
Aunt depressive disorder | 1 (5.6) | 0 | 1 (3) |
Median (Interquartile Range) | Difference | 95% CI (Confidence Interval) | p * | ||
---|---|---|---|---|---|
Healthy Controls | Patients | ||||
IL-6 | 0.95 (0.296–2.518) | 1.54 (0.871–2.35) | 0.41 | 0.14–0.76 | 0.006 |
CRP | 1.40 (0.90–2.15) | 2.90 (1.10–6.0) | 0.80 | 0.10–2.20 | 0.002 |
Albumin | 46.0 (44.0–48.0) | 44.05 (42.0–47.0) | −2 | −3–(−1) | 0.002 |
Zinc | 12.20 (10.67–14.02) | 13.20 (11.43–15.38) | 1.22 | 0.23–2.11 | 0.013 |
Median (Interquartile Range) | p * | |||
---|---|---|---|---|
Control Group | Unipolar Depression | Bipolar Depression | ||
IL-6 | 0.95 (0.296–2.518) | 1.54 (0.82–2.76) | 1.53 (0.96–2.26) | 0.020 † |
CRP | 1.40 (0.90–2.15) | 3.40 (1.0–5.70) | 2.45 (1.10–6.80) | 0.008 † |
Albumin | 46.0 (44.0–48.0) | 44.80 (42.10–47.0) | 44.0 (42.0–47.0) | 0.007 † |
Zinc | 12.20 (10.67–14.02) | 13.40 (11.9–15.5) | 13.15 (10.40–15.0) | 0.013 ‡ |
Median (Interquartile Range) | Difference | 95% CI (Confidence Interval) | p * | ||
---|---|---|---|---|---|
Unipolar Depression | Bipolar Depression | ||||
Zinc | 13.4 (11.9–15.5) | 13.2 (10.4–15) | −0.8 | −1.7–0.3 | 0.134 |
Albumin | 44.8 (42.1–47.0) | 44.0 (42–47) | 0 | −1.6–1.0 | 0.825 |
CRP | 3.4 (1.0–5.7) | 2.5 (1.1–6.8) | 0.1 | −0.7–0.8 | 0.718 |
IL-6 | 1.54 (0.82–2.76) | 1.53 (0.96–2.26) | −0.006 | −0.44–0.36 | 0.962 |
Unipolar Depression Items on HAMD-17 Scale | Spearman’s Correlation Coefficient Rho (p Value) | |||
---|---|---|---|---|
Zinc | Albumin | CRP | IL-6 | |
Depressed mood | 0.085 (0.50) | −0.087 (0.49) | 0.019 (0.88) | −0.035 (0.79) |
Guilt feelings | 0.019 (0.88) | −0.103 (0.42) | 0.006 (0.96) | −0.293 (0.02) |
Suicide thoughts | 0.040 (0.75) | −0.160 (0.21) | 0.037 (0.77) | 0.074 (0.56) |
Insomnia-early | 0.093 (0.46) | 0.060 (0.64) | 0.020 (0.88) | 0.093 (0.47) |
Insomnia-middle | −0.031 (0.80) | 0.049 (0.70) | −0.024 (0.85) | 0.002 (0.99) |
Insomnia-late | 0.130 (0.30) | 0.160 (0.21) | 0.014 (0.91) | −0.112 (0.38) |
Work and activities | −0.226 (0.07) | −0.238 (0.06) | 0.253 (0.04) | 0.319 (0.01) |
Retardation psychomotor | 0.008 (0.95) | −0.193 (0.13) | 0.166 (0.19) | 0.221 (0.08) |
Agitation | 0.238 (0.06) | 0.077 (0.55) | −0.115 (0.36) | −0.063 (0.62) |
Anxiety-psychic | −0.035 (0.78) | 0.079 (0.54) | 0.249 (0.05) | 0.114 (0.37) |
Anxiety-somatic | 0.217 (0.08) | 0.264 (0.04) | 0.011 (0.93) | −0.054 (0.67) |
Gastrointestinal symptoms | −0.247 (0.05) | −0.104 (0.41) | 0.064 (0.61) | 0.091 (0.48) |
Somatic symptoms. general | −0.227 (0.07) | −0.159 (0.21) | 0.281 (0.02) | 0.424 (<0.001) |
Sexual disturbances | −0.082 (0.52) | −0.016 (0.90) | 0.083 (0.51) | 0.107 (0.41) |
Hypochondriasis (somatization) | −0.109 (0.39) | −0.303 (0.01) | 0.095 (0.45) | 0.122 (0.34) |
Weight loss | −0.231 (0.06) | −0.249 (0.05) | 0.364 (<0.001) | 0.277 (0.03) |
Insight | −0.074 (0.56) | −0.164 (0.19) | 0.046 (0.72) | 0.166 (0.19) |
HAMD−17 total | −0.027 (0.83) | −0.091 (0.47) | 0.227 (0.07) | 0.177 (0.16) |
Bipolar Depression | Spearman’s Correlation Coefficient Rho (p Value) | |||
---|---|---|---|---|
Zinc | Albumin | CRP | IL-6 | |
Depressed mood | −0.072 (0.57) | −0.239 (0.05) | 0.052 (0.68) | 0.133 (0.29) |
Guilt feelings | −0.110 (0.38) | −0.341 (0.01) | 0.145 (0.25) | 0.050 (0.69) |
Suicidal thoughts | −0.001 (0.99) | −0.174 (0.16) | −0.071 (0.57) | 0.037 (0.77) |
Insomnia: initial | 0.050 (0.69) | −0.069 (0.58) | 0.154 (0.22) | −0.053 (0.68) |
Insomnia: middle | 0.082 (0.51) | 0.124 (0.32) | 0.194 (0.12) | −0.104 (0.41) |
Insomnia: late | 0.164 (0.19) | 0.205 (0.1) | 0.187 (0.13) | −0.084 (0.51) |
Work and activities | −0.182 (0.14) | −0.342 (<0.001) | 0.093 (0.46) | 0.250 (0.04) |
Psychomotor retardation | 0.125 (0.32) | 0.043 (0.73) | −0.008 (0.95) | 0.039 (0.76) |
Psychomotor agitation | 0.176 (0.16) | −0.062 (0.62) | 0.019 (0.88) | −0.225 (0.07) |
Anxiety. psychic | 0.396 (<0.001) | 0.059 (0.64) | 0.040 (0.75) | −0.307 (0.01) |
Anxiety. somatic | 0.088 (0.48) | 0.082 (0.51) | 0.202 (0.10) | −0.150 (0.23) |
Gastrointestinal symptoms | −0.366 (<0.001) | −0.231 (0.06) | 0.225 (0.07) | 0.254 (0.04) |
Somatic symptoms. general | −0.253 (0.04) | −0.270 (0.03) | 0.206 (0.10) | 0.458 (<0.001) |
Sexual disturbances | 0.035 (0.78) | 0.075 (0.55) | 0.046 (0.71) | −0.009 (0.94) |
Hypochondriasis (somatization) | −0.111 (0.38) | −0.011 (0.93) | 0.206 (0.10) | 0.032 (0.80) |
Weight loss | −0.327 (0.01) | −0.129 (0.30) | 0.122 (0.33) | 0.152 (0.23) |
Insight | −0.018 (0.89) | −0.095 (0.45) | 0.028 (0.82) | −0.105 (0.40) |
HAMD-17 total | −0.082 (0.51) | −0.211 (0.09) | 0.239 (0.05) | 0.024 (0.85) |
Unipolar Depression | Spearman’s Correlation Coefficient Rho (p Value) | |||
---|---|---|---|---|
Zinc | Albumin | CRP | IL-6 | |
Apparent sadness | 0.079 (0.53) | 0.068 (0.59) | 0.238 (0.06) | 0.113 (0.38) |
Reported sadness | 0.171 (0.17) | 0.003 (0.98) | 0.087 (0.49) | −0.059 (0.65) |
Inner tension | −0.019 (0.88) | −0.200 (0.11) | 0.138 (0.27) | 0.160 (0.21) |
Reduced sleep | 0.135 (0.28) | −0.045 (0.73) | 0.165 (0.19) | 0.056 (0.67) |
Reduced appetite | 0.006 (0.96) | −0.167 (0.19) | −0.065 (0.61) | 0.081 (0.53) |
Concentration difficulties | −0.170 (0.18) | −0.181 (0.15) | 0.262 (0.04) | 0.278 (0.03) |
Lassitude | −0.191 (0.13) | −0.051 (0.69) | 0.228 (0.07) | 0.345 (0.01) |
Inability to feel | −0.115 (0.36) | −0.029 (0.82) | 0.114 (0.37) | 0.109 (0.39) |
Pessimistic thoughts | −0.049 (0.70) | −0.163 (0.20) | 0.200 (0.11) | 0.070 (0.59) |
Suicidal thoughts | −0.109 (0.39) | −0.053 (0.68) | 0.221 (0.08) | 0.238 (0.06) |
MADRS total | −0.005 (0.97) | −0.124 (0.33) | 0.219 (0.08) | 0.184 (0.15) |
Bipolar Depression | Spearman’s Correlation Coefficient Rho (p Value) | |||
---|---|---|---|---|
Zinc | Albumin | CRP | IL-6 | |
Apparent sadness | 0.029 (0.82) | −0.259 (0.04) | 0.120 (0.34) | 0.062 (0.62) |
Reported sadness | −0.055 (0.66) | −0.201 (0.11) | 0.167 (0.18) | 0.070 (0.58) |
Inner tension | 0.002 (0.99) | −0.062 (0.62) | 0.099 (0.43) | −0.153 (0.22) |
Reduced sleep | 0.096 (0.44) | −0.130 (0.30) | 0.118 (0.34) | −0.012 (0.92) |
Reduced appetite | −0.338 (0.01) | −0.264 (0.03) | 0.159 (0.20) | 0.151 (0.23) |
Concentration difficulties | −0.051 (0.69) | −0.272 (0.03) | 0.135 (0.28) | 0.101 (0.42) |
Lassitude | −0.174 (0.16) | −0.231 (0.06) | 0.384 (<0.001) | 0.245 (0.05) |
Inability to feel | −0.165 (0.19) | −0.221 (0.08) | 0.131 (0.29) | 0.073 (0.57) |
Pessimistic thoughts | −0.068 (0.59) | −0.183 (0.14) | 0.136 (0.28) | −0.046 (0.72) |
Suicidal thoughts | −0.156 (0.21) | −0.172 (0.17) | 0.075 (0.55) | 0.102 (0.42) |
MADRS total | −0.066 (0.60) | −0.253 (0.04) | 0.185 (0.14) | 0.064 (0.61) |
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Bagarić, T.; Mihaljević-Peleš, A.; Skočić Hanžek, M.; Živković, M.; Kozmar, A.; Rogić, D. Serum Levels of Zinc, Albumin, Interleukin-6 and CRP in Patients with Unipolar and Bipolar Depression: Cross Sectional Study. Curr. Issues Mol. Biol. 2024, 46, 4533-4550. https://doi.org/10.3390/cimb46050275
Bagarić T, Mihaljević-Peleš A, Skočić Hanžek M, Živković M, Kozmar A, Rogić D. Serum Levels of Zinc, Albumin, Interleukin-6 and CRP in Patients with Unipolar and Bipolar Depression: Cross Sectional Study. Current Issues in Molecular Biology. 2024; 46(5):4533-4550. https://doi.org/10.3390/cimb46050275
Chicago/Turabian StyleBagarić, Tihana, Alma Mihaljević-Peleš, Milena Skočić Hanžek, Maja Živković, Ana Kozmar, and Dunja Rogić. 2024. "Serum Levels of Zinc, Albumin, Interleukin-6 and CRP in Patients with Unipolar and Bipolar Depression: Cross Sectional Study" Current Issues in Molecular Biology 46, no. 5: 4533-4550. https://doi.org/10.3390/cimb46050275