Background: Atrophic chronic gastritis (ACG) is a preneoplastic condition of gastric carcinoma.Numerous studies have shown anxiety and depression can affect gastrointestinal function, which may promote gastrointestinal disorders development and progression. Thus, we hypothesized that anxiety and depression may enhance the development and progression of ACG. In this study, we aimed to analyse risk factors for anxiety and depression in ACG patients and integrate these risk factors to construct an effective clinical prediction model.
Methods:In total, 118 ACG patients were included from July 2021 to May 2022. Anxiety and depression were assessed utilizing the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Data were collected on demographic characteristics, lifestyle, and dietary habits. Risk factors for anxiety and depression were explored with univariate analysis and multivariate stepwise logistic regression, and risk prediction models were built.Results: Among 118 ACG patients, 36.4% had anxiety, 25.4% had depression, and 21.2% had both anxiety and depression. Poor sleep quality [odd ratio (OR) 4.32, 95% confidence interval (CI): 1.60-11.65, P=0.004] was positively associated with risk of anxiety, while smoking (OR 0.15, 95% CI: 0.03-0.68, P=0.014) and weekly exercise time (OR 0.89, 95% CI: 0.79-0.99, P=0.037) were negatively associated with risk of anxiety.The area under the receiver operating characteristic (ROC) curve was 80.3%, 95% CI: [0.722-0.885].
Attractin (ATRN) is a widely expressed glycoprotein that is involved in energy homeostasis, neurodevelopment, and immune response. It is encoded by a gene spanning 180 kb on chromosome 20p13, a region previously implicated in schizophrenia by linkage studies. To address a possible role of ATRN in disorders of the central nervous system, we created an atrn knockout zebrafish line and performed behavioral tests. Adult atrn–/– zebrafish exhibited more pronounced attack behavior relative to wild-type control zebrafish in a tracking analysis. Biochemical analysis revealed elevated testosterone levels in atrn–/– zebrafish. At the gene expression level, we noted an upregulation of cyp51 and hsd17b7, key proteins in testosterone synthesis in the brains of both adult and larvae of atrn–/– zebrafish. In order to further elucidate the relationship between testosterone and behavioral syndromes, we then compared testosterone levels of 9,008 psychiatric patients and 247 healthy controls from the same catchment area. Of all subjects examined, male subjects with schizophrenia exhibited lower testosterone levels compared with controls. In contrast, female subjects with a diagnosis of schizophrenia or bipolar disorder featured higher testosterone levels than did same sex controls. Purposeful sampling of extreme groups showed reduced ATRN expression in a subset of these subjects. Finally, we identified 14 subjects with ATRN mutations. All of whom displayed abnormal testosterone levels. In summary, the interplay of ATRN and testosterone may help to explain sexual dimorphisms in selected behavioral phenotypes.
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