【摘要】 目的 评估血清脂联素(adiponectin)联合瘦素(leptin)预测广泛性焦虑障碍(GAD)治疗疗效的价值。方法 选取2024年1月—2025年1月187例GAD患者为GAD组，另选取同期健康体检者187例为对照组。采用酶联免疫吸附试验检测血清脂肪因子adiponectin、leptin水平。根据治疗疗效将GAD患者分为缓解组[汉密尔顿焦虑量表(HAMA)评分≤7分]与未缓解组(HAMA评分>7分);采用多因素Logistic回归分析探讨GAD患者治疗疗效的影响因素；采用受试者工作特征(ROC)曲线分析血清adiponectin联合leptin对GAD患者治疗疗效的预测价值。结果 与对照组比较，GAD组血清adiponectin水平降低，leptin水平升高，差异有统计学意义(P<0.001)。187例GAD患者治疗后的未缓解率为48.66%(91/187)。单因素分析结果显示，缓解组与未缓解组患者的HAMA评分、广泛性焦虑障碍量表(GAD-7)评分、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、leptin水平以及adiponectin水平比较，差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示，HAMA评分增加(OR=1.245, 95%CI:1.074～1.443,P=0.004)、GAD-7评分增加(OR=1.254, 95%CI:1.036～1.516,P=0.020)、leptin升高(OR=1.446, 95%CI:1.235～1.693,P<0.001)是GAD患者治疗未缓解的独立危险因素，adiponectin升高(OR=0.544, 95%CI:0.430～0.688,P<0.001)是独立保护因素。血清adiponectin、leptin水平单独以及联合预测GAD患者治疗疗效的ROC曲线的曲线下面积分别为0.808、0.792、0.898,敏感度分别为0.725、0.802、0.791,特异度分别为0.708、0.635、0.833,二者联合的预测价值高于血清adiponectin、leptin水平单独预测，差异有统计学意义(P<0.05)。结论 血清adiponectin水平降低以及leptin水平升高与GAD治疗反应不佳密切相关，二者联合对GAD患者治疗疗效的预测价值较高。更多还原

【Abstract】 Objective To evaluate the value of serum adiponectin combined with leptin in predicting the therapeutic efficacy for patients with generalized anxiety disorder(GAD). Methods A total of 187 patients with GAD from January 2024 to January 2025 were selected as the GAD group, and 187 healthy individuals with physical examinations in the same period were selected as the control group. Enzyme-linked immunosorbent assay was used to detect the serum levels of adiponectin and leptin. According to the therapeutic efficacy, patients with GAD were divided into remission group [Hamilton Anxiety Scale(HAMA) score≤7 points] and non-remission group(HAMA score > 7 points). MultivariateLogistic regression analysis was used to explore the influencing factors of therapeutic efficacy in pa-tients with GAD. The receiver operating characteristic(ROC) curve analysis was used to analyzethe predictive value of serum adiponectin combined with leptin for the therapeutic efficacy in patientswith GAD.Results Compared with the control group, the serum adiponectin level in the GADgroup decreased significantly, while the leptin level increased significantly(P< 0. 001). The non-remission rate in the 187 patients with GAD after treatment was 48. 66%(91/187). Univariate a-nalysis results showed that there were significant differences in HAMA score, the Generalized Anxie-ty Disorder-7(GAD-7) score, fasting blood glucose, total cholesterol, low-density lipoprotein cho-lesterol, leptin level, and adiponectin level between the remission group and the non-remissiongroup(P< 0. 05). Multivariate Logistic regression analysis showed that an increase in HAMA score(OR = 1. 245, 95% CI, 1. 074 to 1. 443,P= 0. 004), an increase in GAD-7 score(OR = 1. 254,95% CI, 1. 036 to 1. 516,P= 0. 020), and an elevation in leptin level(OR = 1. 446, 95% CI,1. 235 to 1. 693,P< 0. 001) were independent risk factors for non-remission in patients with GAD,while an elevation in adiponectin level(OR = 0. 544, 95% CI, 0. 430 to 0. 688,P< 0. 001) was anindependent protective factor. The areas under the curve of the ROC curves for serum adiponectinlevel alone, leptin level alone, and their combined prediction of therapeutic efficacy in patients withGAD were 0. 808, 0. 792, and 0. 898 respectively, with sensitivities of 0. 725, 0. 802, and 0. 791respectively, and specificities of 0. 708, 0. 635, and 0. 833 respectively. The predictive value oftheir combination was significantly higher than that of serum adiponectin or leptin level alone(P<0. 05).Conclusion A decreased serum adiponectin level and an increased leptin level are closelyrelated to poor treatment response in patients with GAD, and their combination has a relatively highpredictive value for the therapeutic efficacy in patients with GAD.更多还原