The association between peptic ulcer disease and depression risk: The role of serotonin as a diagnostic biomarker in a case-control study.
TL;DR
Serotonin may have diagnostic value as a biomarker associated with depressive symptoms in patients with PUD, but longitudinal studies including women and PUD patients without depression are required.
Abstract
Aim
To evaluate serum serotonin levels in patients with peptic ulcer disease (PUD) and assess its potential as a biomarker associated with depressive symptoms in patients with PUD.
Methods
This case-control study included 50 adult male patients with endoscopically confirmed PUD and 50 apparently healthy male controls. Serum serotonin levels were measured using enzyme-linked immunosorbent assay (ELISA). Depression was diagnosed by a psychologist and assessed using the Patient Health Questionnaire-9 (PHQ-9). Statistical analyses included the Mann-Whitney U test, chi-square test, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis.
Results
Patients with PUD had higher PHQ-9 scores than controls, with a median score of 13.5 (7.0-16.6) versus 4.0 (2.0-8.0) (p<0.001). Serum serotonin levels were lower in patients with PUD than in controls, with a median of 530.086 (435.7-592.8) pg/mL versus 1008.763 (874.89-1120.43) pg/mL (p<0.001). In the adjusted model, lower serotonin levels remained independently associated with comorbid PUD-depression status (OR=0.992; 95% CI 0.988-0.996; p<0.001). ROC analysis showed high diagnostic performance for serotonin in the full sample (AUC=0.920; 95% CI 0.870-0.970; cut-off 803.131 pg/mL; sensitivity 85.0%; specificity 100%).
Conclusion
Serum serotonin levels were lower in male patients with PUD and depressive symptoms than in healthy controls. Serotonin may have diagnostic value as a biomarker associated with depressive symptoms in patients with PUD, but longitudinal studies including women and PUD patients without depression are required.