Biomedical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea.
Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea.
J Psychosom Res. 2023 Dec;175:111502. doi: 10.1016/j.jpsychores.2023.111502. Epub 2023 Sep 28.
Increasing evidence suggests a positive association between insulin resistance (IR) and depression. However, whether sex-or body mass index-specific differences exist remains controversial, and only few studies have analyzed specific symptom domains. Thus, the present study aimed to analyze the association between IR and depressive symptom domains and to clarify the effects of sex and body mass index.
The study sample comprised 4007 participants, aged 19-79, from the Korea National Health and Nutrition Examination Study 2020. Participants completed health interviews and examinations, providing data on circulating insulin and glucose levels, the Patient Health Questionnaire-9 (PHQ-9), and related covariates. IR was calculated using the homeostasis model assessment of insulin resistance. Associations between IR and PHQ-9 were analyzed using negative binomial regression with adjustments for the complex survey design.
The association between log-transformed IR and PHQ-9 total scores was statistically significant (incidence rate ratio [IRR] = 1.17, 95% confidence interval [CI] = 1.07-1.29, p = 0.001). Only body mass index specific differences were statistically significant, as the association was only significant in those without obesity (IRR = 1.21, 95% CI = 1.06-1.38, p = 0.005). IR was associated with cognitive/affective (IRR = 1.23, 95% CI = 1.08-1.41, p = 0.002) and somatic (IRR = 1.14, 95% CI = 1.04-1.25, p = 0.005) depressive symptom domains. Sensitivity analyses revealed similar results.
IR was positively associated with cognitive/affective and somatic depressive symptoms in non-obese individuals.
越来越多的证据表明，胰岛素抵抗（IR）与抑郁之间存在正相关关系。然而，性别或体重指数特异性差异是否存在仍存在争议，并且只有少数研究分析了特定的症状领域。因此，本研究旨在分析 IR 与抑郁症状领域之间的关联，并阐明性别和体重指数的影响。
研究样本包括 2020 年韩国国家健康和营养检查调查的 4007 名年龄在 19-79 岁的参与者。参与者完成了健康访谈和检查，提供了有关循环胰岛素和葡萄糖水平、患者健康问卷-9（PHQ-9）和相关协变量的数据。使用稳态模型评估胰岛素抵抗来计算 IR。使用负二项回归分析调整复杂调查设计后，分析 IR 与 PHQ-9 之间的关联。
log 转换后的 IR 与 PHQ-9 总分之间存在统计学显著关联（发病率比 [IRR] = 1.17，95%置信区间 [CI] = 1.07-1.29，p = 0.001）。只有体重指数特异性差异具有统计学意义，因为这种关联仅在没有肥胖的人群中显著（IRR = 1.21，95% CI = 1.06-1.38，p = 0.005）。IR 与认知/情感（IRR = 1.23，95% CI = 1.08-1.41，p = 0.002）和躯体（IRR = 1.14，95% CI = 1.04-1.25，p = 0.005）抑郁症状领域相关。敏感性分析显示出类似的结果。
在非肥胖个体中，IR 与认知/情感和躯体抑郁症状呈正相关。
