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Higher serum VGF protein levels discriminate bipolar depression from major depressive disorder
Authors:Suzhen Chen  Haitang Jiang  Zhenhua Hou  Yingying Yue  Yuqun Zhang  Fuying Zhao  Zhi Xu  Yinghui Li  Xiaodong Mou  Lei Li  Tianyu Wang  Jingjing Zhao  Chongyang Han  Yuxiu Sui  Ming Wang  Zhong Yang  Yan Lu  Yifeng Zhu  Jianhua Li  Xinhua Shen  Fei Sun  Qingsong Chen  Yonggui Yuan
Affiliation:1. Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China

Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China;2. Department of Psychiatry, Brain Hospital, Nanjing Medical University, Nanjing, PR China;3. Department of Psychiatry, The Third People's Hospital of Changshu, Suzhou, PR China;4. Department of Psychiatry, The Fourth People's Hospital of Zhangjiagang, Suzhou, PR China;5. Department of Psychiatry, The Third People's Hospital of Huzhou, Huzhou, PR China;6. Department of Psychiatry, The Second People's Hospital of Jingjiang, Taizhou, PR China;7. Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China

Abstract:
Misdiagnosis between major depressive disorder (MDD) and bipolar depression (BD) is quite common. Our previous study found significantly lower serum VGF (non-acronymic) in MDD patients. However, it is unclear whether same changes occur in BD patients. Therefore, we aimed to investigate the relationship between serum VGF levels in BD and MDD patients. General information, scores of 17-item Hamilton Depression Rating Scale (HDRS), and fasting blood samples of all participants including 30 MDD patients, 20 BD patients, and 30 healthy controls (HC) were collected. Serum VGF levels were measured by Enzyme-linked immunosorbent assay kits. Pearson correlation analysis was used to analyze correlations between serum VGF levels and clinical information. Receiver operating characteristic (ROC) curve and likelihood ratios (LRs) were used to analyze the differential potential of serum VGF. Serum VGF levels were significantly lower in MDD patients but higher in BD patients compared with HC (both PTukey < 0.01). No correlation was found between serum VGF levels and any data of subjects. The optimal cutoff for serum VGF in discriminating BD patients from MDD patients was ≥1093.85 pg/ml (AUC = 0.990, sensitivity of 95%, specificity of 100% and accuracy of 95%). LRs further confirmed the differential efficiency of serum VGF in distinguishing BD and MDD patients with +LR of infinity and –LR of 0. The results suggest that serum VGF level changed significantly in MDD and BD patients and serum VGF may be an indicator for differentiating BD patients from MDD patients.
Keywords:bipolar depression  diagnosis  differentiation  major depressive disorder  VGF
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