Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China.
Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.
Sci Rep. 2023 May 18;13(1):8078. doi: 10.1038/s41598-023-35290-6.
Comorbid glucose metabolism abnormalities are very common in patients with major depressive disorder (MDD), and glucose metabolism and lipid metabolism are closely related. However, there are few researches on the incidence and related factors of lipid metabolism abnormalities among MDD patients with comorbid glucose metabolism abnormalities. A cross-sectional study involving 1718 first-episode and drug-naïve (FEDN) MDD patients was conducted. The 17-item Hamilton Depression Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) positive subscale were utilized to evaluate depressive, anxiety and psychotic symptom, respectively. Serum thyroid function-related parameters, glucose- and lipid-metabolism parameters were measured. The prevalence of abnormal lipid metabolism was significantly higher in FEDN MDD patients with abnormal glucose metabolism than in those without abnormal glucose metabolism (P < 0.001). In MDD patients with abnormal glucose metabolism, TSH, FT3 and body mass index (BMI) levels were significantly higher in the abnormal lipid metabolism subgroup than in the non-abnormal lipid metabolism subgroup. Binary logistic regression analysis showed that TSH, FT3 and BMI were the influencing factors of abnormal lipid metabolism in MDD patients with abnormal glucose metabolism (all P < 0.05). MDD patients with abnormal glucose metabolism have a high prevalence of abnormal lipid metabolism. Moreover, abnormal glucose metabolism was an independent risk factor for abnormal lipid metabolism in patients with MDD. In addition, thyroid hormone function and BMI may contribute to the co-occurrence of abnormal lipid metabolism in MDD patients with abnormal glucose metabolism.
患有重性抑郁障碍(MDD)的患者常合并葡萄糖代谢异常,且葡萄糖代谢与脂代谢密切相关。然而,关于 MDD 合并葡萄糖代谢异常患者脂代谢异常的发生率及其相关因素的研究较少。本研究纳入了 1718 例首发未用药的 MDD 患者,采用汉密尔顿抑郁量表 17 项(HAMD-17)、汉密尔顿焦虑量表(HAMA)和阳性与阴性症状量表(PANSS)阳性分量表分别评估抑郁、焦虑和精神病性症状,检测血清甲状腺功能相关参数、糖脂代谢参数。结果显示,与葡萄糖代谢正常的 MDD 患者相比,葡萄糖代谢异常的 MDD 患者脂代谢异常的发生率显著更高(P<0.001)。在葡萄糖代谢异常的 MDD 患者中,脂代谢异常亚组的 TSH、FT3 和 BMI 水平均显著高于非脂代谢异常亚组。二元 logistic 回归分析显示,TSH、FT3 和 BMI 是 MDD 合并葡萄糖代谢异常患者脂代谢异常的影响因素(均 P<0.05)。综上,MDD 合并葡萄糖代谢异常患者脂代谢异常的发生率较高,且葡萄糖代谢异常是 MDD 患者脂代谢异常的独立危险因素。此外,甲状腺激素功能和 BMI 可能导致 MDD 合并葡萄糖代谢异常患者脂代谢异常的共病发生。