Kang Chuanyi, Liu Jiacheng, Zheng Yue, Wang Xiaohong, Yang Liying, Qiu Siyu, Zhao Ying, Lackey Blake N, Wu Hanjing Emily, Zhao Na, Zhang Xiangyang
Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Heilongjiang Province, Harbin, China.
Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.
Eur Arch Psychiatry Clin Neurosci. 2023 Feb;273(1):183-190. doi: 10.1007/s00406-022-01415-7. Epub 2022 May 12.
Thyroid dysfunction is known to be associated with obesity, but the reliability of this relationship is easily affected by drug treatment, age, and subclinical hypothyroidism (SCH) with no apparent symptoms. Our research aims to compare obese and overweight BMI ranges with SCH and without SCH in a large sample of young, first-episode and drug-naïve (FEDN) patients with major depressive disorder (MDD), which has received little systemic investigation. A total of 1289 FEDN MDD young outpatients were recruited for this study. Serum thyroid function and lipid level parameters were measured; HAMD and PANSS scales were used to assess patients' depression and positive symptoms. A self-administered questionnaire collected other clinical and demographic data. The prevalence of SCH in FEDN MDD young patients was 58.26%. Compared to patients without SCH, the patients with SCH had a more prolonged illness duration, higher BMI levels, increased prevalence of overweight and obesity, higher HAMD score and PANSS-positive symptom scores, higher levels of TG, TC, LDL-C, and lower levels of HDL-C. Further logistic regression indicated that overweight BMI, obese BMI, illness duration, HAMD score, HDL-C, and TC were significantly associated with SCH. Our results indicate that obesity and overweight may be associated with SCH in young, FEDN MDD patients. The importance of regular thyroid function assessment in young FEDN MDD patients with high BMI should be taken into account.
甲状腺功能障碍已知与肥胖有关，但这种关系的可靠性很容易受到药物治疗、年龄以及无明显症状的亚临床甲状腺功能减退（SCH）的影响。我们的研究旨在比较大量首次发作且未接受过药物治疗的年轻重性抑郁症（MDD）患者中，伴有和不伴有SCH的肥胖和超重BMI范围，此前这方面几乎没有系统性研究。本研究共招募了1289名首次发作且未接受过药物治疗的年轻MDD门诊患者。测量了血清甲状腺功能和血脂水平参数；使用汉密尔顿抑郁量表（HAMD）和阳性与阴性症状量表（PANSS）评估患者的抑郁和阳性症状。通过一份自填式问卷收集了其他临床和人口统计学数据。首次发作且未接受过药物治疗的年轻MDD患者中SCH的患病率为58.26%。与无SCH的患者相比，有SCH的患者病程更长、BMI水平更高、超重和肥胖的患病率增加、HAMD评分和PANSS阳性症状评分更高、TG、TC、LDL-C水平更高，而HDL-C水平更低。进一步的逻辑回归表明，超重BMI、肥胖BMI、病程、HAMD评分、HDL-C和TC与SCH显著相关。我们的结果表明，肥胖和超重可能与首次发作且未接受过药物治疗的年轻MDD患者的SCH有关。应考虑对BMI较高的首次发作且未接受过药物治疗的年轻MDD患者进行定期甲状腺功能评估的重要性。
