Huang Xiao, Sun Yuan, Zhang Xiangyang
Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China.
Metabolites. 2023 Dec 30;14(1):26. doi: 10.3390/metabo14010026.
Overweight and obesity are frequent symptoms in patients with major depressive disorder (MDD) and abnormal lipid metabolism (ALM). There are no studies on the rate, risk factors, and underlying mechanisms of overweight/obesity in Chinese patients with MDD with comorbid ALM. The purpose of this study was to examine the rate of overweight/obesity and the associated risk factors among Chinese patients with MDD first-episode and drug-naïve (FEDN) with comorbid ALM. This study was a cross-sectional research work. A total of 1718 patients were enrolled. Their clinical and laboratory data were obtained. All participants were assessed with the 17-item Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA), and the Positive and Negative Syndrome Scale (PANSS) positive subscale. The plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triacylglycerols (TG), blood glucose concentrations, thyroid peroxidase antibody (A-TPO), thyoglubulin antibody (A-TG), thyroid-stimulating hormone (TSH), free thyoxine (FT4) and free triiodothyronine (FT3), and blood glucose concentrations were measured. ALM was identified as elevations in the plasma lipid values in this study. Of all the included subjects, the rate of ALM was 81.1%. The rate of obesity and overweight was 3.94% and 57.21%, respectively. Logistic regression analysis showed that TSH was the independent risk factor for overweight or obesity in MDD patients (adjusted OR = 1.158, 95%CI = 1.081-1.24, < 0.001). The risk of developing overweight or obesity in MDD with ALM with comorbid TSH abnormalities was 2.176 times higher than those without TSH abnormalities ( < 0.001). Further linear regression showed TSH level (B = 0.1, t = 3.376, = 0.001) and systolic blood pressure (B = 0.015, t = 2.351, = 0.019) were risk factors for a higher body mass index (BMI). Our results demonstrate that being overweight is very frequent among patients with FEDN MDD with comorbid ALM but not obesity. TSH was the risk factor for overweight and obesity in MDD patients with comorbid ALM.
超重和肥胖是重度抑郁症(MDD)和脂质代谢异常(ALM)患者的常见症状。目前尚无关于合并ALM的中国MDD患者超重/肥胖的发生率、危险因素及潜在机制的研究。本研究旨在探讨合并ALM的首发未用药中国MDD患者(FEDN)中超重/肥胖的发生率及相关危险因素。本研究为横断面研究。共纳入1718例患者,获取了他们的临床和实验室数据。所有参与者均接受17项汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及阳性和阴性症状量表(PANSS)阳性分量表评估。检测血浆总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、血糖浓度、甲状腺过氧化物酶抗体(A-TPO)、甲状腺球蛋白抗体(A-TG)、促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)以及血糖浓度。本研究中,ALM被定义为血浆脂质值升高。在所有纳入的受试者中,ALM的发生率为81.1%。肥胖和超重的发生率分别为3.94%和57.21%。逻辑回归分析显示,TSH是MDD患者超重或肥胖的独立危险因素(调整后的比值比=1.158,95%置信区间=1.081-1.24,P<0.001)。合并ALM且TSH异常的MDD患者发生超重或肥胖的风险比无TSH异常者高2.176倍(P<0.001)。进一步的线性回归显示,TSH水平(B=0.1,t=3.376,P=0.001)和收缩压(B=0.015,t=2.351,P=0.019)是体重指数(BMI)升高的危险因素。我们的结果表明,合并ALM的FEDN MDD患者中超重很常见,但肥胖并不常见。TSH是合并ALM的MDD患者超重和肥胖的危险因素。