[Comparative analysis of serum glutamate and gamma-aminobutyric acid levels in patients with bipolar depressive disorder and major depression disorder].

Objective: To investigate the difference of serum glutamate (Glu) and gamma- aminobutyric acid (GABA) levels between depressive patients and bipolar disorder patients with depressive episodes. Methods: From May 2018 to March 2019, forty-seven patients with depression (depression group) and 45 patients with bipolar depressive episode (bipolar depression group) were selected from the department of psychiatry, the First Affiliated Hospital of Jinan University, and 41 healthy controls (healthy control group) were simultaneously recruited from the community. The subjects' depression and anxiety were assessed by 17 items of Hamilton depression scale (HAMD-17) and Hamilton Anxiety Scale (HAMA). The serum levels of Glu, GABA and Glu decarboxylase (GAD) were detected by enzyme-linked immunosorbent assay (ELISA) . Results: The serum Glu level ( (36±7) mg/L, (37±7) mg/L vs (28±4) mg/L, F=10.97, P<0.01) and Glu/GABA ratio (5.77±0.35, 8.18±0.24 vs 3.35±0.33, F=37.68, P<0.01) in depression and bipolar depression groups were higher than those of healthy control group, while the GABA level ((6.1±0.7) μmol/L,(4.1±0.8) μmol/L vs (8.1±1.2) μmol/L, F=21.61, P<0.01) and GAD ((31±6) U/L, (31±6) U/L vs (35±6) U/L, F=5.61, P<0.01) were lower than those of healthy control group. The level of serum GABA in bipolar depression group was lower than that in depression group. However, Glu/GABA was higher in bipolar depression group than that in depression group (P<0.01). The level of serum GABA in depression group was negatively correlated with HAMD sleep disorder factor (r=-0.46, P=0.01). Conclusions: Both depression and bipolar depression have abnormal levels of Glu, GABA neurotransmitters and imbalance between Glu and GABA in peripheral blood circulation. Moreover, these abnormalities are more obvious in patients with bipolar depression.目的： 探讨双相障碍抑郁发作与抑郁症患者血清谷氨酸（Glu）及γ-氨基丁酸（GABA）水平差异。 方法： 选择2018年5月至2019年3月在暨南大学附属第一医院精神医学科就诊的抑郁症患者（抑郁症组）47例、双相障碍抑郁发作患者（双相抑郁组）45例，社区招募健康对照（健康对照组）41名，以17项汉密尔顿抑郁量表（HAMD-17）、汉密尔顿焦虑量表（HAMA）评定被试抑郁、焦虑症状，采用酶联免疫吸附法检测被试血清Glu、GABA、Glu脱羧酶（GAD）水平，计算Glu/GABA比例。 结果： 抑郁症组与双相抑郁组血清Glu[（36±7）mg/L、（37±7）mg/L比（28±4）mg/L，F=10.97，P<0.01]、Glu/GABA比例（5.77±0.35、8.18±0.24比3.35±0.33，F=37.68，P<0.01）高于健康对照组，而GABA[（6.1±0.7）μmol/L、（4.1±0.8）μmol/L比（8.1±1.2）μmol/L，F=21.61，P<0.01]与GAD[（31±6）U/L、（31±6）U/L比（35±6）U/L，F=5.61，P<0.01]水平则低于健康对照组，并且双相抑郁组血清GABA水平低于抑郁症组，Glu/GABA比例则高于抑郁症组（P<0.01）；抑郁症组血清GABA水平与HAMD睡眠障碍因子呈负相关（r=-0.46，P=0.01）。 结论： 抑郁症与双相障碍抑郁发作均存在外周血液循环Glu、GABA能神经递质水平异常以及Glu与GABA平衡紊乱，并且双相障碍抑郁发作患者GABA能神经递质水平异常以及Glu与GABA平衡紊乱更为明显。.