Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Psychology, Zhongshan City People's Hospital, China.
J Affect Disord. 2024 Mar 15;349:400-406. doi: 10.1016/j.jad.2024.01.014. Epub 2024 Jan 8.
Both abnormal glucose metabolism and anxiety have been reported to be common in major depressive disorder (MDD). However, few studies have explored glucose disturbances in first-episode and drug-naive (FEDN) MDD patients with anxiety. The purpose of this study was to examine the prevalence and risk factors of glucose disturbance in FEND MDD patients comorbid with anxiety.
1718 FEDN MDD patients were included in this study. The positive subscale of the Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD) were used to measure psychotic, anxiety and depressive symptoms respectively. Sociodemographic and biochemical indicators were also collected.
The prevalence of glucose disorders in MDD patients combined with anxiety was 15.7 %, significantly higher than in MDD patients without anxiety symptoms (7.1 %). Glucose disturbances were associated with HAMD score, HAMA score, thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), anti-thyroglobulin (TGAb), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), suicide attempts, and psychotic symptoms. Further logistic regression showed that illness duration, TSH, TGAb, and TPOAb levels were correlates of glucose disturbances in MDD patients with anxiety.
No causal relationship could be drawn due to the cross-sectional design.
Our findings suggest that TSH, TGAb and TPOAb may be promising biomarkers of glucose disturbances in MDD comorbid with anxiety, suggesting the importance of regular assessment of thyroid function parameters for abnormal glucose metabolism prevention.
葡萄糖代谢异常和焦虑在重度抑郁症（MDD）中都很常见。然而，很少有研究探讨伴有焦虑的首发未用药 MDD（FEDN）患者的葡萄糖紊乱。本研究旨在探讨伴有焦虑的 FEDN MDD 患者葡萄糖紊乱的患病率及其危险因素。
纳入了 1718 例首发未用药 MDD 患者。采用阳性和阴性综合征量表（PANSS）阳性量表、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）的阳性量表评估精神病性、焦虑和抑郁症状。同时收集人口统计学和生化指标。
伴焦虑的 MDD 患者中葡萄糖紊乱的患病率为 15.7%，明显高于无焦虑症状的 MDD 患者（7.1%）。葡萄糖紊乱与 HAMD 评分、HAMA 评分、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、抗甲状腺球蛋白抗体（TGAb）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白（LDL-C）、空腹血糖（FBG）、收缩压（SBP）、舒张压（DBP）、自杀企图和精神病性症状有关。进一步的 logistic 回归显示，病程、TSH、TGAb 和 TPOAb 水平与伴焦虑的 MDD 患者的葡萄糖紊乱相关。
由于采用的是横断面设计，因此不能得出因果关系。
我们的研究结果表明，TSH、TGAb 和 TPOAb 可能是伴焦虑的 MDD 患者葡萄糖紊乱的有前途的生物标志物，这表明定期评估甲状腺功能参数对预防异常葡萄糖代谢很重要。
