Nanjing Meishan Hospital, Nanjing, 210041, PR China.
Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China.
BMC Psychiatry. 2024 May 21;24(1):382. doi: 10.1186/s12888-024-05818-9.
Evidence regarding the relationship between fasting blood glucose (FBG) and suicide attempts (SA) in patients with major depressive disorder (MDD) was limited. Therefore, the objective of this research was to investigate whether FBG was independently related to SA in Chinese patients with first-episode drug-naïve (FEDN) MDD after adjusting for other covariates.
The present study was a cross-sectional study. A total of 1718 participants (average age: 34.9 ± 12.4 years, 65.8% females) with FEDN MDD were involved in a hospital in China from September 2016 to December 2018. Multiple logistic regression analysis and smooth curve fitting were used to estimate the association between FBG and the risk of SA. The threshold effect was examined by the two-piecewise linear regression model. Interaction and stratified analyses were conducted according to sex, education, marital status, comorbid anxiety, and psychotic symptoms.
The prevalence of SA in patients with FEDN MDD was 20.1%. The result of fully adjusted binary logistic regression showed FBG was positively associated with the risk of SA (odds ratio (OR) = 1.62, 95% CI: 1.13-2.32). Smoothing plots also revealed a nonlinear relationship between FBG and SA, with the inflection point of FBG being 5.34 mmol/l. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.53 (0.32-0.88, P = 0.014) and 1.48 (1.04-2.10, P = 0.030), respectively.
A U-shaped relationship between FBG and SA in FEDN MDD patients was found, with the lowest risk of SA at a FBG of 5.34 mmol/l, indicating that both the lower and higher FBG levels may lead to an increased risk of SA.
有关空腹血糖（FBG）与首发未用药的抑郁障碍（MDD）患者自杀未遂（SA）之间关系的证据有限。因此，本研究旨在调查在中国首发未用药的 MDD 患者中，在调整其他协变量后，FBG 是否与 SA 独立相关。
本研究为横断面研究。2016 年 9 月至 2018 年 12 月，共纳入 1718 名首发未用药的 MDD 患者（平均年龄：34.9±12.4 岁，65.8%为女性）参与中国某医院的研究。采用多因素逻辑回归分析和光滑曲线拟合来评估 FBG 与 SA 风险之间的关系。采用两段线性回归模型来检验阈值效应。根据性别、教育程度、婚姻状况、共病焦虑和精神病性症状进行交互和分层分析。
首发未用药 MDD 患者中 SA 的患病率为 20.1%。经完全校正的二元逻辑回归结果显示，FBG 与 SA 风险呈正相关（比值比（OR）=1.62，95%可信区间：1.13-2.32）。平滑图也显示了 FBG 与 SA 之间的非线性关系，FBG 的拐点为 5.34mmol/L。拐点左右两侧的效应大小和置信区间分别为 0.53（0.32-0.88，P=0.014）和 1.48（1.04-2.10，P=0.030）。
在首发未用药的 MDD 患者中，FBG 与 SA 之间存在 U 型关系，FBG 为 5.34mmol/L 时 SA 风险最低，表明较低和较高的 FBG 水平都可能导致 SA 风险增加。
