Costemale-Lacoste Jean-François, Asmar Khalil El, Rigal Adrien, Martin Séverine, Kader Ait Tayeb Abd El, Colle Romain, Becquemont Laurent, Fève Bruno, Corruble Emmanuelle
Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « Dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France.
Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « Dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Beirut, 1107 2020, Lebanon.
J Affect Disord. 2020 Mar 1;264:513-518. doi: 10.1016/j.jad.2019.11.084. Epub 2019 Nov 13.
Major depression is associated with metabolic syndrome and cardiovascular risk. We have previously shown that severe insomnia, a core symptom of major depression episode (MDE), is associated with hypertriglyceridemia, a component of metabolic syndrome, in women but not in men with major depression. Since insomnia is related to cardiovascular morbidity in the general population and major depression also, our objective was to assess the link between insomnia and metabolic syndrome, a marker syndrome of cardiovascular risk, during MDE, in women and in men.
In 624 patients with a current MDE cohort, both insomnia and metabolic syndrome were assessed in women and men. Insomnia was rated from 0 to 6 based on the HDRS corresponding items, severe insomnia being defined by a total insomnia score ≥4.
severe insomnia was associated with metabolic syndrome in women but not in men. In multivariate logistic regressions, these results in women were independent from age, educational level, major depressive disorder duration and current smoking. These results were only significant in women aged ≥50 years, a cut-off age for menopausal status but not in women under 50 years.
Women aged ≥50 years with a severe insomnia during MDE have an increased risk of metabolic syndrome. Severe insomnia may be a clinical marker of metabolic risk in this population. They should be particularly monitored for metabolic syndrome and may benefit from sleep recommendations and cardiovascular prevention.
重度抑郁症与代谢综合征及心血管风险相关。我们之前已经表明，严重失眠作为重度抑郁发作（MDE）的核心症状，在患有重度抑郁症的女性中与代谢综合征的一个组成部分——高甘油三酯血症相关，而在男性中则不然。由于失眠在普通人群以及重度抑郁症患者中均与心血管疾病发病率相关，我们的目标是评估在MDE期间，女性和男性中失眠与代谢综合征（一种心血管风险的标志性综合征）之间的联系。
在624名当前患有MDE的队列患者中，对女性和男性的失眠及代谢综合征进行了评估。根据汉密尔顿抑郁量表（HDRS）的相应项目，将失眠程度从0到6进行评分，严重失眠定义为总失眠得分≥4。
严重失眠与女性的代谢综合征相关，但与男性无关。在多因素逻辑回归分析中，女性的这些结果独立于年龄、教育水平、重度抑郁症病程及当前吸烟情况。这些结果仅在年龄≥50岁的女性中具有统计学意义，50岁是绝经状态的一个分界年龄，而在50岁以下的女性中则不然。
年龄≥50岁且在MDE期间患有严重失眠的女性患代谢综合征的风险增加。严重失眠可能是该人群代谢风险的一个临床标志物。应对她们进行代谢综合征的特别监测，她们可能会从睡眠建议和心血管预防措施中受益。
