Associations of decreased serum total protein, albumin, and globulin with depressive severity of schizophrenia

Xu Yuan Yin; Yuan Cai; Zhen Hua Zhu; Chang Ping Zhai; Jian Li; Cai Fang Ji; Peng Chen; Jing Wang; Yi Ming Wu; Raymond C K Chan; Qiu Fang Jia; Li Hui

doi:10.3389/fpsyt.2022.957671

Associations of decreased serum total protein, albumin, and globulin with depressive severity of schizophrenia

Front Psychiatry. 2022 Jul 25:13:957671. doi: 10.3389/fpsyt.2022.957671. eCollection 2022.

Authors

Xu Yuan Yin¹, Yuan Cai¹, Zhen Hua Zhu¹, Chang Ping Zhai², Jian Li³, Cai Fang Ji¹, Peng Chen¹, Jing Wang¹, Yi Ming Wu⁴, Raymond C K Chan⁵, Qiu Fang Jia¹, Li Hui¹

Affiliations

¹ Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou Medical College of Soochow University, Suzhou, China.
² Bengbu Mental Health Center, Anhui Veterans Hospital, Anmin Hospital Affiliated to Bengbu Medical College, Bengbu, China.
³ Changshu No. 2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, China.
⁴ Shanghai Yangpu Mental Health Center, Shanghai, China.
⁵ CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.

Abstract

Objective: Depression and schizophrenia (SCH) were accompanied by an acute phase response (APR) that was implicated in the alterations in total protein (TP), albumin, and globulin levels. The aims of this study are to examine serum TP, albumin, globulin levels, depressive symptoms, and their associations in patients with SCH.

Methods: We recruited 34 patients with SCH and 136 healthy controls (HCs) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Psychiatric symptoms and biomarkers were assessed using the Chinese version of the Positive and Negative Syndrome Scale (PANSS) as well as the bromocresol green and biuret methods.

Results: Serum TP (F = 46.11, p < 0.001, η2 = 0.19), albumin (F = 31.69, p < 0.001, η2 = 0.14), and globulin (F = 12.48, p < 0.001, η2 = 0.06) levels were lower in patients than those in HCs after adjusting for covariates. Serum TP (r = -0.37, p = 0.03) and albumin (r = -0.37, p = 0.03) levels were negatively correlated with depressive score in patients. Stepwise multivariate regression analysis showed the negative associations of depressive score with serum TP (β = -0.13, t = -2.92, p = 0.007), albumin (β = -0.23, t = -2.36, p = 0.03), and globulin (β = -0.16, t = -2.40, p = 0.02) levels in patients. Serum TP, albumin, and globulin levels exhibited the accuracies of 87.1, 70.0, and 69.4% in discriminating between patients and HCs (area under the curve [AUC]: 0.78, 0.68, and 0.77; sensitivity/specificity: 52.9%/95.6%, 55.9%/73.5%, and 76.5%/67.6%).

Conclusion: Our data suggested that decreased serum TP, albumin, and globulin should be regarded as the SCH risk factors and were implicated in the depressive severity of SCH, which further provided the support for the hypothesis that SCH and depression were accompanied by the abnormal inflammatory cytokines with the APR.

Keywords: albumin; depressive symptom; globulin; schizophrenia; total protein.