Study the HPA axis function, volume of the adrenal and pituitary glands in elderly patients with ;depression / 实用医学杂志

ABSTRACT

Objective To investigate the changes of hypothalamic-pituitary-adrenal axis (HPA)function, volume of the hypothalamic, pituitary and adrenal glands in elderly patients with depression. Methods Twenty-five cases of elderly patients with depression and 19 healthy elderly patients were enrolled into the patient group and the healthy control group, respectively. Enzyme linked immunosorbent assay was used to measure the level of the main hormone related with HPA axis in blood. The low dose dexamethasone suppression test was used to assessassessment the negative feedback regulation of HPA axis. The volume of the hypothalamus, pituitary and adrenal glands were determined by the magnetic resonance imaging. Results The Beck Depression Scale (BDI-II) and Montgomerie Rating Scale (MADRs) score of the elderly depression patients were significantly higher than those in the healthy control group (P < 0.01). The values of main hormone related with HPA axis in the patient group, such as CRH, ACTH and CORT, were higher than those in the healthy control group (P<0.01). The non- suppression rate of low dose dexamethasone suppression test in the patient group was significantly higher than that in the healthy control group (P < 0.05). The hypothalamus, pituitary and adrenal gland volume of patients group were 4.7%, 18.3% and 17.5% ,respectively. Significant the differences of pituitary and adrenal volume were observed between two groups (P < 0.05). Conclusion The levels of main hormone related with HPA axis in the elderly patients with depression were significantly increased, the non-suppression rate of low dose dexamethasone suppression test was also increased. Meanwhile, the volume of pituitary and adrenal gland in the elderly patients with depression increased.