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Objective: The incidence of non-suicidal self-injury (NSSI) behavior in adolescents is increasing year by year. Patients with a history of both depression and NSSI behavior tend to be at greater risk for suicide. At present, the mechanism of adolescent depressive disorder with NSSI behavior is not clear and still in research and exploration. The expression of the Silent Information Regulator 2 Related Enzyme 1 (SIRT1) gene is closely related to the level of serotonin in molecular mechanisms, and may be closely related to the occurrence and development of depressive disorder. This study aimed to explore the relationship between the SIRT1 gene and NSSI behaviors in adolescents with depressive disorder.Methods: A total of 15 adolescent depressed patients with NSSI behavior and 15 healthy controls were enrolled in the study. Bisulfite Sequencing PCR (BSP) was used to test the methylation level of SIRT1 gene promoter region of the participants. The realtime fluorescent quantitative PCR was conducted to measure the mRNA expression level of SIRT1 gene.Results: Our study found that the methylation level of SIRT1 gene promoter region at cytosine-guanine dinucleotide 5 (CpG5) site in depression group was higher than that of control group. Compared with that of control group, the plasma concentration of Sirt1 protein significantly decreased in depression group. Conclusion:Our study investigated the methylation level and the mRNA expression of SIRT1 gene in adolescent depressive patients with NSSI behavior. The study points towards finding an in vivo molecular marker for those adolescent patients. Abbreviations: 5-HT = 5-hydroxy trptamine, CpG5 = cytosine-guanine dinucleotide5, DSM-5 = 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, MAO-A = Monoamine oxidase A, NSSI = nonsuicidal self-injury, PCR = polymerase chain reaction, SIRT1 = silent information regulator 2 related enzyme 1.

Abstract Background The incidence of non-suicidal self-injury (NSSI) behavior among adolescents increases year by year. Patients with a history of both depression and NSSI behaviors tend to have greater risk of suicide. At present, the mechanism of adolescent depressive disorder patients with NSSI behaviors is not clear, epigenetic mechanism may be involved. Proopiomelanocortin (POMC) gene may be associated with depressive disorder. The purpose of this study was to investigate deoxyribonucleic acid (DNA) methylation of POMC gene promoter region of adolescent depressive disorder patients with NSSI behaviors. Methods Bisulfite Sequencing PCR (BSP) was used to test the methylation level of POMC promoter of 15 adolescent depressive disorder patients with NSSI behaviors and 15 healthy controls (HC). The online software Methylation Share Rate (MSR) Calcalate was used to draw the lollipop model of the methylation state. Self-made questionnaires were used to collect clinical data of the case group and control group. Hamilton depression scale-24 (HAMD-24), Hamilton anxiety scale (HAMA), Symptom Checklist-90 (SCL-90) were used to evaluate the characteristics and severity of depressive, anxiety and psychotic symptoms. Adolescent self-injury questionnaire was used to assess NSSI behaviors and its severity. Results BSP analysis found that the POMC methylation level of cytosine-guanine dinucleotide 1 (CpG1) site was higher in adolescent depressive disorder patients with NSSI behaviors than that of HC (P < 0.05). Overall significance in POMC methylation at CpG1 sites between adolescent depressive disorder patients with NSSI behaviors and HC was gender-independent, methylation level at CpG1 sites was higher in both male and female patients than that in HC. The CpG1 methylation had correlation with the family history (P < 0.05). We also found that POMC methylation level at CpG17 sites in female patients was significantly higher than that of the female HC (P < 0.05). Conclusions There was abnormal methylation in the POMC promoter region of adolescent depressive disorder patients with NSSI behaviors, the methylation of CpG1 sites may act as epigenetic markers for those adolescents.