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性别在与肥胖和抑郁共病相关的糖化血红蛋白水平上的差异。

Sex Differences in Hemoglobin A1c Levels Related to the Comorbidity of Obesity and Depression.

机构信息

Division of Women's Health, Department of Medicine, Boston, Massachusetts, USA.

Department of Psychiatry, Boston, Massachusetts, USA.

出版信息

J Womens Health (Larchmt). 2021 Sep;30(9):1303-1312. doi: 10.1089/jwh.2020.8467. Epub 2021 Feb 2.

Abstract

Obesity (OB) and major depressive disorder (MDD) are chronic conditions associated with disease burden, and their comorbidity appears more common among women. Mechanisms linking these conditions may involve inflammatory and metabolic pathways. The goal of this study was to evaluate the impact of MDD on relationships between OB and cardiometabolic function, and sex differences therein. Adult offspring from the New England Family Studies (NEFS) were assessed at ages 39-50, including anthropometry, cardiometabolic profile assays, and metabolic syndrome. Individuals were grouped by body mass index (BMI) and MDD status: healthy weight with ( = 50) or without MDD ( = 95) and obese with ( = 79) or without MDD ( = 131). The interaction of (recurrent) MDD and BMI on cardiometabolic markers was tested using quantile regression models. Participants with MDD exhibited significantly higher hemoglobin A1c (HbA1c) than those without MDD (5.60% vs. 5.35%,  < 0.05). Women with comorbid recurrent MDD and OB had higher HbA1c levels compared to obese women without MDD (5.75% vs. 5.44%,  < 0.05); an interaction between MDD and BMI status was not observed among men. We demonstrated sex differences in the interaction between BMI and recurrent MDD status on a primary biomarker for diabetes risk, suggesting a common metabolic pathway predisposing women to these comorbid conditions. Further investigation is needed to identify mechanisms that may lead to more effective, sex-dependent screening and therapies.

摘要

肥胖症(OB)和重度抑郁症(MDD)是与疾病负担相关的慢性疾病,且其共病在女性中更为常见。将这些情况联系起来的机制可能涉及炎症和代谢途径。本研究的目的是评估 MDD 对 OB 与心脏代谢功能之间关系的影响,以及其中的性别差异。

新英格兰家庭研究(NEFS)的成年后代在 39-50 岁时进行评估,包括人体测量、心脏代谢特征分析和代谢综合征。个体根据体重指数(BMI)和 MDD 状态分组:有( = 50)或无( = 95)MDD 的健康体重人群和有( = 79)或无( = 131)MDD 的肥胖人群。使用分位数回归模型检验(复发性)MDD 和 BMI 对心脏代谢标志物的相互作用。

患有 MDD 的参与者的血红蛋白 A1c(HbA1c)水平明显高于无 MDD 的参与者(5.60%比 5.35%, < 0.05)。患有复发性 MDD 和 OB 的女性与无 MDD 的肥胖女性相比,HbA1c 水平更高(5.75%比 5.44%, < 0.05);未观察到男性中 MDD 和 BMI 状态之间的交互作用。

我们证明了 BMI 和复发性 MDD 状态之间的相互作用在糖尿病风险的主要生物标志物上存在性别差异,这表明存在共同的代谢途径使女性易患这些共病。需要进一步研究以确定可能导致更有效、性别依赖的筛查和治疗的机制。

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