Changes in serum levels of OXA,IL-33 and IGF-1 in adolescent patients with depression and their relationship with sleep disorders

HE Dandan; LI Jiaoli; ZHAO Furong

doi:10.13431/j.cnki.immunol.j.20260021

Abstract：Objective To investigate the changes in serum levels of orexin A(OXA),interleukin-33(IL-33),and insulin-like growth factor-1(IGF-1)in adolescent patients with depression,and to analyze their association with sleep disorders.Methods From January to December 2023,146 adolescent patients with depression were selected.According to the Pittsburgh Sleep Quality Index(PSQI),they were divided into the normal sleep group(n=54)and the sleep disorder group(n=92).The sleep disorder group was subdivided into mild subgroup(n=26),moderate subgroup(n=41),and severe subgroup(n=25)according to the severity.And 110 healthy individuals undergoing physical examination during the same period were enrolled as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect and compare the serum levels of OXA,IL-33,and IGF-1 in the control group,normal sleep group,sleep disorder group,and adolescent depressive patients with different severities of sleep disorders.Spearman correlation analysis was used to investigate the relationship between serum levels of OXA,IL-33 and IGF-1 and PSQI scores in adolescent depressive patients with sleep disorders.Multivariate logistic regression analysis was used to investigate the influencing factors of the occurrence of sleep disorders in adolescent depressive patients.Receiver operating characteristic(ROC)curves was drawn to analyze the diagnostic value of serum levels of OXA,IL-33,and IGF-1 in the occurrence of sleep disorders in adolescent depressive patients.Results The serum levels of OXA and IL-33 in the sleep disorder group were higher than those in the normal sleep group and the control group,while the serum level of IGF-1 was lower than that in the normal sleep group and the control group;the serum levels of OXA and IL-33 in the normal sleep group were also higher than those in the control group,while the serum level of IGF-1 was also lower than that in the control group(P＜0.05).The serum levels of OXA and IL-33 increased sequentially in the mild,moderate,and severe subgroups,while the serum level of IGF-1 decreased sequentially(P＜0.05).The serum levels of OXA and IL-33 were positively correlated with PSQI score in adolescent depressive patients with sleep disorders(linear R2=0.328,0.446,P＜0.001),while the serum level of IGF-1 was negatively correlated with PSQI score in adolescent depressive patients with sleep disorders(linear R2=-0.343,P≤0.001).The results of multivariate logistic regression analysis showed that serum levels of OXA and IL-33 were risk factors for the occurrence of sleep disorders in adolescent depressive patients,while the serum IGF-1 level was a protective factor(P＜0.05,P＜0.01).The area under curve(AUC)for the combined diagnosis of sleep disorders by the three indicators in adolescent patients with depression was 0.926,with a sensitivity and a specificity of 93.48％and 75.00％,respectively,which was superior to their individual diagnoses(Zcombined-OXA=2.250,Zcombined-IL-33=2.203,Zcombined-IGF-1=2.375,P=0.024,0.028,0.018).Conclusion The serum levels of OXA and IL-33 in adolescent depressive patients are elevated,while the serum level of IGF-1 is reduced.The serum levels of OXA,IL-33,and IGF-1 are closely related to the occurrence of sleep disorders in adolescent depressive patients.The combined detection of the three is of great significance for the diagnosis and treatment of sleep disorders in adolescent depressive patients.