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首发未用药的重度抑郁症患者甘油三酯葡萄糖指数与自杀未遂之间的关联

Association between triglyceride glucose index and suicide attempts in patients with first-episode drug-naïve major depressive disorder.

作者信息

Liu Junjun, Zhu Xiaomin, Liu Yang, Jia Fengnan, Yuan Hsinsung, Wang Qingyuan, Zhang Xiaobin, Li Zhe, Du Xiangdong, Zhang Xiangyang

机构信息

Nanjing Meishan Hospital, Nanjing, China.

Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.

出版信息

Front Psychiatry. 2023 Jul 28;14:1231524. doi: 10.3389/fpsyt.2023.1231524. eCollection 2023.

Abstract

OBJECTIVE

Triglyceride glucose (TyG) index has been suggested as an alternative indicator of insulin resistance (IR); however, the association between TyG index and suicide attempts (SA) in major depressive disorder (MDD) is unclear. The aim of this study was to investigate the relationship between TyG index and SA in Chinese patients with first-episode drug-naïve (FEDN) MDD.

METHODS

This cross-sectional study enrolled 1,718 patients with FEDN MDD aged 34.9 ± 12.4 years from the First Hospital of Shanxi Medical University (Taiyuan, Shanxi Province, China) from September 2016 to December 2018. Multivariable binary logistic regression analysis was used to estimate the association between TyG index and the risk of SA. A two-piecewise linear regression model was used to investigate the threshold effects if non-linearity associations existed. Interaction and stratified analyses were performed based on sex, education, marital status, comorbid anxiety, and psychotic symptoms.

RESULTS

Multivariable logistic regression analysis revealed that TyG index was positively associated with the risk of SA after adjusting for confounders (OR = 1.35, 95% CI: 1.04-1.75,  = 0.03). Smoothing plots also showed a nonlinear relationship between TyG index and SA, with the inflection point of TyG index being 9.29. On the right of the inflection point, a positive association between TyG index and SA was detected (OR = 3.47, 95% CI: 1.81 to 6.66,  < 0.001), while no significant association was observed on the left side of the inflection point (OR = 1.14, 95% CI: 0.79 to 1.66,  = 0.476).

CONCLUSION

The relationship between TyG index and SA risk was non-linear and exhibited a threshold effect in Chinese patients with FEDN MDD. When TyG index was greater than 9.29, they showed a significant positive correlation.

摘要

目的

甘油三酯葡萄糖(TyG)指数已被提议作为胰岛素抵抗(IR)的替代指标;然而,TyG指数与重度抑郁症(MDD)患者自杀未遂(SA)之间的关联尚不清楚。本研究旨在调查中国首发未用药(FEDN)的MDD患者中TyG指数与SA之间的关系。

方法

这项横断面研究纳入了2016年9月至2018年12月期间来自山西医科大学第一医院(中国山西省太原市)的1718例年龄为34.9±12.4岁的FEDN的MDD患者。采用多变量二元逻辑回归分析来估计TyG指数与SA风险之间的关联。如果存在非线性关联,则使用两段式线性回归模型来研究阈值效应。基于性别、教育程度、婚姻状况、共病焦虑和精神病性症状进行交互作用和分层分析。

结果

多变量逻辑回归分析显示,在调整混杂因素后,TyG指数与SA风险呈正相关(OR = 1.35,95%CI:1.04 - 1.75,P = 0.03)。平滑图还显示TyG指数与SA之间存在非线性关系,TyG指数的拐点为9.29。在拐点右侧,检测到TyG指数与SA之间存在正相关(OR = 3.47,95%CI:1.81至6.66,P < 0.001),而在拐点左侧未观察到显著关联(OR = 1.14,95%CI:0.79至1.66,P = 0.476)。

结论

在中国FEDN的MDD患者中,TyG指数与SA风险之间的关系是非线性的,并表现出阈值效应。当TyG指数大于9.29时,它们显示出显著的正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a740/10416446/45dba00a45b6/fpsyt-14-1231524-g001.jpg

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