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中国首发未经药物治疗的重性抑郁障碍患者的超重和肥胖的流行率及相关因素。

Prevalence and risk factors of overweight and obesity in Chinese patients with first-episode drug-naïve major depressive disorder.

机构信息

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

J Affect Disord. 2021 May 1;286:351-359. doi: 10.1016/j.jad.2021.01.037. Epub 2021 Jan 14.

Abstract

BACKGROUNDS

Obesity and overweight are common in patients with major depressive disorder (MDD); the results are inconsistent due to confounding variables involved in studies. Furthermore, no well-designed study has been published to investigate the prevalence, risk factors and underlying mechanisms of obesity/overweight in Chinese MDD patients. This study aimed to investigate the prevalence of obesity/overweight and related risk factors in first-episode, drug-naïve (FEDN) patients with MDD in China.

METHODS

A total of 1718 patients were recruited. Their clinical and anthropometric data, thyroid function and biochemical parameters were collected. All patients were evaluated on the 17-item Hamilton Rating Scale for Depression, 14-item Hamilton Anxiety Rating Scale and the Positive and Negative Syndrome Scale.

RESULTS

The prevalence of obesity and overweight was 3.73% and 56.00%, respectively. Multivariable logistic regression analysis showed that TSH was the only independent risk factor for weight gain in MDD patents. The fitting curve of the relationship between TSH and BMI formed an inverted U-shaped parabola. The ordinal logit mode showed that when TSH<=2.68 was set as a reference, the odd rates of weight increased with the increase of TSH, and the highest rate was 3.929 (95%CI: 2.879-5.361, P<0.0001).

LIMITATION

Causality cannot be drawn due to cross-sectional design.

CONCLUSION

Our results suggest that overweight is very common among patients with FEDN MDD rather than obesity. TSH is a promising predictor and potential biomarker of high weight in MDD patients, and there is an inverted U-shaped parabolic relationship between TSH and BMI.

摘要

背景

肥胖和超重在患有重度抑郁症(MDD)的患者中很常见;由于研究中涉及混杂变量,结果不一致。此外,尚未发表设计良好的研究来调查中国 MDD 患者肥胖/超重的患病率、危险因素和潜在机制。本研究旨在调查中国首发、未用药(FEDN)MDD 患者肥胖/超重的患病率及相关危险因素。

方法

共纳入 1718 例患者。收集其临床和人体测量学数据、甲状腺功能和生化参数。所有患者均接受 17 项汉密尔顿抑郁量表(HAMD-17)、14 项汉密尔顿焦虑量表(HAMA-14)和阳性和阴性症状量表(PANSS)评估。

结果

肥胖和超重的患病率分别为 3.73%和 56.00%。多变量逻辑回归分析表明,TSH 是 MDD 患者体重增加的唯一独立危险因素。TSH 与 BMI 之间关系的拟合曲线呈倒 U 形抛物线。有序逻辑模式显示,当 TSH<=2.68 设为参考时,体重增加的几率随 TSH 的增加而增加,最高几率为 3.929(95%CI:2.879-5.361,P<0.0001)。

局限性

由于横断面设计,不能得出因果关系。

结论

我们的研究结果表明,FEDN MDD 患者中体重超重很常见,而不是肥胖。TSH 是 MDD 患者体重增加的一个有前途的预测指标和潜在生物标志物,TSH 与 BMI 之间呈倒 U 形抛物线关系。

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