Department M3/Internal Medicine IV, University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, Târgu Mureş, Romania.
Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, Târgu Mureş, Romania.
Psychiatry Clin Neurosci. 2019 Dec;73(12):745-753. doi: 10.1111/pcn.12922. Epub 2019 Sep 9.
The associations of serum leptin/soluble leptin receptor (sObR) and leptin resistance with symptoms of depression and anxiety were investigated in patients with type 2 diabetes (T2D).
We report the results of two cross-sectional studies, performed 2 years apart, that included 216 and 237 T2D patients, respectively. Symptoms of depression and anxiety were assessed with specific questionnaires (Patient Health Questionnaire-9, Center for Epidemiologic Studies Depression Scale, and Generalized Anxiety Disorder-7, respectively). Laboratory data (including leptin and sObR) were collected, and free leptin index (FLI), as an estimate of leptin resistance, was calculated. One hundred forty patients had laboratory data available on both occasions, and were evaluated longitudinally. Simple and multiple correlations between depression/anxiety and parameters of interest were performed.
In both studies, serum leptin levels were higher, whereas resting energy expenditure/leptin ratios were lower in T2D patients with depressive and moderate-severe anxiety symptoms. In the second study, patients with depressive symptoms had higher FLI and lower sObR levels, while those with moderate-severe anxiety only had higher FLI. Depression scores correlated with serum leptin (r = 0.29, [95%CI: 0.14-0.42]; r = 0.32, [95%CI: 0.18-0.45]) and FLI (r = 0.30, [95%CI: 0.15-0.43]; r = 0.32, [95%CI: 0.17-0.45]; P < 0.0001 for all). Multiple regression analyses identified leptin (β = 0.167; t ratio = 1.98) and FLI (β = 2.935, t ratio = 2.44) (P < 0.05 for both) as variables that significantly contributed to depressive symptoms. Depressive symptoms were present in significantly more patients with leptin levels in the highest versus the lowest quartiles on both evaluations (odds ratio: 5.98, 95%CI [1.76-20.32], P < 0.01).
Depressive and moderate-severe anxiety symptoms were associated with high leptin concentrations and leptin resistance in T2D patients.
研究 2 型糖尿病（T2D）患者血清瘦素/可溶性瘦素受体（sObR）和瘦素抵抗与抑郁和焦虑症状的关系。
我们报告了两项相隔 2 年的横断面研究结果，分别纳入了 216 名和 237 名 T2D 患者。使用特定的问卷（患者健康问卷-9、流行病学研究抑郁量表和广泛性焦虑障碍-7）评估抑郁和焦虑症状。收集实验室数据（包括瘦素和 sObR），并计算瘦素抵抗的估计值——游离瘦素指数（FLI）。140 名患者在两次检查时均有实验室数据，并进行了纵向评估。对抑郁/焦虑与感兴趣参数之间的简单和多元相关性进行了分析。
在两项研究中，T2D 患者中伴有抑郁和中度至重度焦虑症状者血清瘦素水平较高，静息能量消耗/瘦素比值较低。在第二项研究中，伴有抑郁症状的患者 FLI 较高，sObR 水平较低，而伴有中度至重度焦虑的患者仅 FLI 较高。抑郁评分与血清瘦素（r = 0.29，[95%CI：0.14-0.42]；r = 0.32，[95%CI：0.18-0.45]）和 FLI（r = 0.30，[95%CI：0.15-0.43]；r = 0.32，[95%CI：0.17-0.45]）呈正相关（P < 0.0001）。多元回归分析确定了瘦素（β = 0.167；t 比 = 1.98）和 FLI（β = 2.935，t 比 = 2.44）（P < 0.05）为与抑郁症状显著相关的变量。在两次评估中，瘦素水平处于最高四分位与最低四分位的患者中，出现抑郁症状的比例显著更高（比值比：5.98，95%CI [1.76-20.32]，P < 0.01）。
T2D 患者的抑郁和中度至重度焦虑症状与高瘦素浓度和瘦素抵抗有关。
