Endocrinology Unit, Centre for Cardiovascular Sciences, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, Scotland, UK.
Psychosom Med. 2012 Jan;74(1):39-45. doi: 10.1097/PSY.0b013e31823ba8af. Epub 2011 Dec 30.
Depression in Type 2 diabetes is associated with obesity, cardiovascular disease, and mortality. Leptin is a plausible mediating factor because it has been related to obesity, depression, and cardiovascular disease in nondiabetic populations. We sought to assess whether leptin is related to depressive symptoms in people with Type 2 diabetes.
One thousand fifty-seven subjects (48.5% women, mean [standard deviation] age = 67.9 [4.2] years) with Type 2 diabetes were assessed for depressive symptoms using the Hospital Anxiety and Depression Scale and other clinical variables by interview and physical examination. Plasma leptin was determined by radioimmunoassay. Multiple linear regression was performed to assess the relationship between depressive symptoms and ln leptin while adjusting for other covariates. A mediation analysis was performed to test whether depressive symptoms mediated the relationship between obesity and leptin.
In univariate analyses, symptoms of depression were related to leptin in men (r = 0.214, p < .001) and women (r = 0.146, p = .007). When adjusting for other covariates including body mass index, ischemic heart disease, glycated hemoglobin, duration of diabetes, and treatment with antidepressants, insulin, or glucocorticoids, using a hierarchical multiple linear regression, depressive symptoms (ln Hospital Anxiety and Depression Scale-depression score) were significant only in men (B = 0.083, standard error = 0.037, p = .03). In the mediation analysis, depressive symptoms partially mediated the effect of obesity (body mass index) on leptin in men but not in women.
There is a sex difference in the relationship between depressive symptoms and leptin in people with Type 2 diabetes, with a positive association in men but not in women. Adipocyte-derived factors are associated with depressive symptoms in Type 2 diabetes.
2 型糖尿病患者的抑郁与肥胖、心血管疾病和死亡率有关。瘦素是一种合理的中介因素，因为它与非糖尿病人群的肥胖、抑郁和心血管疾病有关。我们试图评估瘦素是否与 2 型糖尿病患者的抑郁症状有关。
1057 名受试者（48.5%为女性，平均[标准差]年龄=67.9[4.2]岁）通过访谈和体格检查，使用医院焦虑和抑郁量表（Hospital Anxiety and Depression Scale）及其他临床变量评估抑郁症状。通过放射免疫测定法测定血浆瘦素。采用多元线性回归分析，在调整其他协变量后，评估抑郁症状与 ln 瘦素之间的关系。进行中介分析以检验抑郁症状是否介导肥胖与瘦素之间的关系。
在单变量分析中，男性（r=0.214，p<0.001）和女性（r=0.146，p=0.007）的抑郁症状与瘦素有关。在调整其他协变量，包括体重指数、缺血性心脏病、糖化血红蛋白、糖尿病病程和使用抗抑郁药、胰岛素或糖皮质激素后，采用分层多元线性回归，抑郁症状（ln 医院焦虑和抑郁量表-抑郁评分）仅在男性中具有统计学意义（B=0.083，标准误=0.037，p=0.03）。在中介分析中，抑郁症状部分中介了肥胖（体重指数）对男性瘦素的影响，但在女性中没有。
2 型糖尿病患者抑郁症状与瘦素之间存在性别差异，男性呈正相关，女性则无。脂肪细胞衍生因子与 2 型糖尿病患者的抑郁症状有关。
