Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Aug 19, 2025; 15(8): 106971
Published online Aug 19, 2025. doi: 10.5498/wjp.v15.i8.106971
Diamine oxidase as a biomarker for depression and disease activity in inflammatory bowel disease: A cross-sectional observational study
Su-Cong Lyu, Guo-Qiang Zhong, Run-Jie Shi, Yan Sun, Jin Li, Ming-Song Li, Ye Chen
Su-Cong Lyu, Ye Chen, Department of Gastroenterology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Guo-Qiang Zhong, Run-Jie Shi, Yan Sun, Department of Gastroenterology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong Province, China
Jin Li, Department of Gastroenterology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, Guangdong Province, China
Ming-Song Li, Department of Gastroenterology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Ye Chen, Integrative Microecology Clinical Center, Shenzhen Hospital, Southern Medical University, Shenzhen 518000, Guangdong Province, China
Author contributions: Chen Y, Li J, Li MS, and Sun Y designed the research study; Lyu SC, Zhong GQ, and Shi RJ performed the research.
Supported by National Natural Science Foundation of China, No. 82270581 and No. 82270546.
Institutional review board statement: This study was approved by the ethics committee and clinical trial registry of the Third Affiliated Hospital of Guangzhou Medical University (approval No. LCYJ-2022-015).
Informed consent statement: All participants completed informed consent forms.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The study dataset is available from the corresponding author at yechen@smu.edu.cn.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ye Chen, MD, PhD, Professor, Department of Gastroenterology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, No. 1838 Baiyun Road North, Baiyun District, Guangzhou 510515, Guangdong Province, China. yechen@smu.edu.cn
Received: March 23, 2025
Revised: June 2, 2025
Accepted: June 24, 2025
Published online: August 19, 2025
Processing time: 139 Days and 2.9 Hours
Abstract
BACKGROUND

Diamine oxidase (DAO) is secreted by epithelial cells in the intestinal villi, and its serum levels are elevated after intestinal mucosal damage. d-lactate (D-LA) is a gut microbial metabolite that can enter the systemic circulation if intestinal barrier function is impaired. Both DAO and D-LA are serum markers of small bowel mucosal integrity, and can be valuable biomarkers of intestinal barrier damage in inflammatory bowel disease (IBD). Intestinal barrier dysfunction was recently found to contribute to psychological symptoms in IBD patients. However, the correlations among DAO, D-LA, psychological symptoms, and disease activity in IBD remain unexplored.

AIM

To explore the correlations between serum markers of intestinal barrier dysfunction and psychological symptoms in IBD.

METHODS

We enrolled of 126 participants in this study. Psychological symptom questionnaires (depression, patient health questionnaire-9; anxiety, generalized anxiety disorder-7; and stress, perceived stress scale) and a quality of life (QOL) questionnaire (IBD questionnaire 32) were collected at the baseline. Serum DAO and D-LA levels were measured to assess intestinal barrier integrity. Receiver operating characteristic (ROC) curves were used to identify candidate markers of psychological symptoms and disease activity in IBD patients. Logistic regression was applied, with DAO as an independent variable for predicting psychological symptoms in IBD.

RESULTS

Serum DAO levels were significantly higher in IBD patients with moderate-to-severe psychological symptoms than in patients with mild or no psychological symptoms. DAO was positively correlated with depression and negatively correlated with QOL in IBD patients. ROC curves revealed that DAO was independently associated with psychological symptoms and clinical activity in patients with IBD. Additionally, logistic regression analysis revealed that each 1-ng/mL increase in DAO levels was significantly associated with an increased risk of psychological symptoms in IBD patients (OR: 1.019, 95%CI: 1.002-1.037). These results highlight the potential of DAO as a novel biomarker for both depression and disease activity in IBD patients.

CONCLUSION

This study indicates that DAO may be associated with depression and disease activity in IBD patients; however, prospective studies are required to validate its causal relationship.

Keywords: Diamine oxidase; Depression; Intestinal barrier dysfunction; Disease activity; Inflammatory bowel disease; Quality of life

Core Tip: Few studies have explored the association between markers of intestinal barrier dysfunction and psychological symptoms in patients with inflammatory bowel disease (IBD). Our study revealed that serum diamine oxidase (DAO) levels were significantly elevated in IBD patients with moderate-to-severe psychological symptoms as compared to those with no or mild psychological symptoms. Furthermore, correlation analysis indicated that DAO was positively associated with depression and negatively associated with quality of life in IBD patients. Additionally, receiver operating characteristic curves confirmed that DAO is associated with clinical disease activity in patients with IBD. This study suggests the potential of DAO as a novel biomarker for predicting psychological symptoms and disease activity in IBD.