Sex differences in zonulin in affective disorders and associations with current mood symptoms

A Maget, N Dalkner, C Hamm, S A Bengesser, F T Fellendorf, M Platzer, R Queissner, A Birner, M Lenger, S Mörkl, A Kohlhammer-Dohr, A Rieger, M Seidl, L Mendel, T Färber, L Wetzlmair, K Schwalsberger, D V Amberger-Otti, H Schöggl, T LahousenB Leitner-Afschar, R Unterweger, S Zelzer, H Mangge, E Z Reininghaus

Research output: Contribution to journalArticlepeer-review


Introduction: The bidirectional connection between the brain and the gut within psychiatric entities has gained increasing scientific attention over the last years. As a regulator of intestinal permeability, zonulin acts as a key player on the interface of this interplay. Like several psychiatric disorders, intestinal permeability was associated with inflammation in previous findings.

Methods: In this study we explored differences in zonulin serum levels in currently depressed (n = 55) versus currently euthymic (n = 37) individuals with an affective disorder. Further, we explored sex differences and possible influences on zonulin and affective symptoms like medication, age, body mass index, and smoking status.

Results: Serum zonulin was significantly higher in females than in men independent from affective status (z = -2.412, p = .016). More specifically, females in the euthymic subgroup had higher zonulin levels than euthymic men (z = -2.114, p = .035). There was no difference in zonulin serum levels in individuals taking or not taking a specific psychopharmacotherapy. We found no correlation between zonulin serum levels and depression severity.

Discussion: Increased serum zonulin levels as a proxy for increased intestinal permeability in women may indicate a state of elevated susceptibility for depression-inducing stimuli.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalJournal of Affective Disorders
Early online date21 Jul 2021
Publication statusPublished - 1 Nov 2021


  • Inflammation
  • Zonulin
  • Affective disorders
  • Intestinal permeability
  • Depression
  • Bipolar disorder


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