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胰岛素抵抗和肥胖,及其与相对年轻人群中抑郁症的关联:来自一个大型英国出生队列的研究结果。

Insulin resistance and obesity, and their association with depression in relatively young people: findings from a large UK birth cohort.

机构信息

Department of Psychiatry, University of Cambridge, Cambridge, England.

Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England.

出版信息

Psychol Med. 2020 Mar;50(4):556-565. doi: 10.1017/S0033291719000308. Epub 2019 Mar 11.

Abstract

BACKGROUND

Depression frequently co-occurs with disorders of glucose and insulin homeostasis (DGIH) and obesity. Low-grade systemic inflammation and lifestyle factors in childhood may predispose to DGIH, obesity and depression. We aim to investigate the cross-sectional and longitudinal associations among DGIH, obesity and depression, and to examine the effect of demographics, lifestyle factors and antecedent low-grade inflammation on such associations in young people.

METHODS

Using the Avon Longitudinal Study of Parents and Children birth cohort, we used regression analyses to examine: (1) cross-sectional and (2) longitudinal associations between measures of DGIH [insulin resistance (IR); impaired glucose tolerance] and body mass index (BMI) at ages 9 and 18 years, and depression (depressive symptoms and depressive episode) at age 18 years and (3) whether sociodemographics, lifestyle factors or inflammation [interleukin-6 (IL-6) at age 9 years] confounded any such associations.

RESULTS

We included 3208 participants. At age 18 years, IR and BMI were positively associated with depression. These associations may be explained by sociodemographic and lifestyle factors. There were no longitudinal associations between DGIH/BMI and depression, and adjustment for IL-6 and C-reactive protein did not attenuate associations between IR/BMI and depression; however, the longitudinal analyses may have been underpowered.

CONCLUSIONS

Young people with depression show evidence of DGIH and raised BMI, which may be related to sociodemographic and lifestyle effects such as deprivation, smoking, ethnicity and gender. In future, studies with larger samples are required to confirm this. Preventative strategies for the poorer physical health outcomes associated with depression should focus on malleable lifestyle factors.

摘要

背景

抑郁常与葡萄糖和胰岛素稳态障碍(DGIH)和肥胖共存。儿童时期的低度系统性炎症和生活方式因素可能使 DGIH、肥胖和抑郁易患。我们旨在研究 DGIH、肥胖和抑郁之间的横断面和纵向关联,并研究人口统计学、生活方式因素和先前低度炎症对年轻人中这些关联的影响。

方法

使用阿冯纵向研究父母和儿童出生队列,我们使用回归分析来检查:(1)DGIH[胰岛素抵抗(IR);葡萄糖耐量受损]和体重指数(BMI)在 9 岁和 18 岁时的横断面和纵向关联,以及(2)抑郁(抑郁症状和抑郁发作)在 18 岁时的横断面和纵向关联,以及(3)社会人口统计学、生活方式因素或炎症[白细胞介素-6(IL-6)在 9 岁时]是否混杂任何此类关联。

结果

我们纳入了 3208 名参与者。在 18 岁时,IR 和 BMI 与抑郁呈正相关。这些关联可能可以用社会人口统计学和生活方式因素来解释。DGIH/BMI 与抑郁之间没有纵向关联,调整 IL-6 和 C 反应蛋白并不能减弱 IR/BMI 与抑郁之间的关联;然而,纵向分析可能力度不够。

结论

患有抑郁的年轻人表现出 DGIH 和 BMI 升高的证据,这可能与社会人口统计学和生活方式因素有关,如贫困、吸烟、种族和性别。未来需要更大样本量的研究来证实这一点。针对与抑郁相关的较差身体健康结果的预防策略应侧重于可改变的生活方式因素。

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