N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls.
BACKGROUND
The dysfunction of hypothalamic-pituitary-adrenal (HPA) axis in major depression includes hyperactivity and reduced feedback inhibition. Atrial natriuretic peptide (ANP) is able to reduce the HPA-axis response to stress and has an anxiolytic effect in rodents and humans. We hypothesized that patients with depression would have an attenuated N-terminal proANP (NT-proANP) response to acute exercise compared to healthy controls. Secondly, we aimed to assess the effect of antidepressants on NT-proANP response to acute exercise.


METHODS
We examined 132 outpatients with mild to moderate depression (ICD-10) and 44 healthy controls, group matched for age, sex, and BMI. We used an incremental bicycle ergometer test as a physical stressor. Blood samples were drawn at rest, at exhaustion, and 15, 30, and 60 min post-exercise.


RESULTS
The NT-proANP response to physical exercise differed between depressed subjects and healthy controls (group×time; F(4,162.9)=10.92; p<0.001). The increase from rest to VO(2max) was 0.98 (SD 0.8) and 1.96 nmol/l (SD 1.1), respectively, for depressed subjects and healthy controls (mean diff: 0.98 nmol/l; 95% CI 0.7-1.3; t=6.63; df=170; p<0.001). The increase in NT-proANP from rest to peak VO(2max) was 1.27 (SD 1.0) and 0.84 nmol/l (SD 0.6), respectively, for unmedicated and medicated patients (mean diff: 0.42 nmol/l; 95% CI 0.1-0.8; t=2.56; df=128; p=0.01).


CONCLUSIONS
We observed an attenuated NT-proANP response to acute physical stress in depressed patients. Antidepressants were associated with an independent suppressive effect on the NT-proANP response.
Psychiatric Center Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. jesper.krogh@regionh.dk
Jesper
J
Krogh
Andreas
A
Ströhle
Asa
A
Westrin
Tobias
T
Klausen
Martin Balslev
MB
Jørgensen
Merete
M
Nordentoft
D000293:Adolescent; D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000378:metabolism*; D003863:Depression / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006262:Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology; D011498:Protein Precursors / Q000097:blood / Q000378:metabolism*; D013997:Time Factors; D055815:Young Adult
C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor