血清代谢物对焦虑抑郁共病认知损伤的影响

Objective To investigate the effect of serum metabolites on cognitive function in patients with comorbid anxiety and depression. Methods Cognitive function was assessed using the THINC-integrated tool (THINC-it) in 57 depressed patients with significant anxiety (D-AN) and 43 depressed patients without overt anxiety (D-NOAN). Partial Pearson correlation analyses were performed to evaluate relationships between cognitive performance and serum biomarkers, including immune cell counts, lipid profiles, uric acid, creatinine, and thyroid hormones. Results Compared to the D-NOAN group, the D-AN group demonstrated significantly poorer performance in the global cognitive test, objective composite test, choice reaction time (CRT), digit symbol substitution test (DSST), and Perceived Deficits Questionnaire for Depression (PDQ-5-D). Meanwhile, serum uric acid and free thyroxine levels were significantly elevated in the D-AN group (P < 0.05) After adjusting for age, sex, years of education, and BMI, uric acid showed significant positive correlations with CRT, objective composite test, and total cognitive test scores in the D-AN group (CRT: r = 0.306 P=0.038; objective test comprehensive score: r = 0.425 P = 0.003 THINC-it total score: r = 0.4 P = 0.006 ) In contrast, free thyroxine exhibited significant negative correlations with CRT in both the D-AN and D-NOAN groups (D-AN group: r = - 0.453 P=0.002: D-NOAN group: -0.399, P=0.029). Conclusion This study verifies that anxiety-depression comorbidity may be associated with more severe cognitive impairment. It further reveals a dual regulatory role of serum metabolites, elevated uric acid may act as a compensatory neuroprotective factor, whereas increased free thyroxine is likely to exacerbate executive dysfunction.