Li Jing, Chen Siyu, Xian Xiaohua, Xian Yin
Nanchong Psychosomatic Hospital, Nanchong 637700, PR China.
Nanchong Psychosomatic Hospital, Nanchong 637700, PR China.
Psychiatry Res. 2025 Jan;343:116311. doi: 10.1016/j.psychres.2024.116311. Epub 2024 Dec 2.
Insulin resistance (IR), a precursor of type 2 diabetes and other metabolic disorders, is becoming more common owing to rising obesity rates. Depression, which affects 4.4 % of the global population, has been linked to IR; however, the findings are inconsistent. The roles of moderating factors in the depression-IR relationship remain underexplored, creating a gap in the current understanding.
Data from six cycles of the National Health and Nutrition Examination Survey (NHANES, 2005-2016), including 6636 participants without diabetes, were analyzed. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores of 5-9 and 10-27 defined as mild and moderate-to-severe depression, respectively. IR was measured using the HOMA2-IR model, with IR defined as a value of ≥ 2.3. Weighted generalized linear models (GLMs) were used to investigate the relationship between depression and IR. Stratified analyses were used to evaluate the potential moderators.
After adjusting for demographic factors and metabolic indicators, the results of GLMs analysis showed that moderate-to-severe depression significantly increased the odds of IR (OR = 1.65, 95 % CI: 1.04-2.61, p = 0.035), especially in non-Hispanic White individuals (OR = 2.64, 95 % CI: 1.39-5.00, p = 0.004). Antidepressant use also reduced this association.
Moderate-to-severe depression was significantly associated with IR, and race/ethnicity and antidepressant use were important moderators. These findings underscore the need for targeted interventions to address both mental and metabolic health risks in high-risk populations.
胰岛素抵抗（IR）是2型糖尿病和其他代谢紊乱的先兆，由于肥胖率上升，其正变得越来越普遍。抑郁症影响着全球4.4%的人口，与IR有关联；然而，研究结果并不一致。调节因素在抑郁症与IR关系中的作用仍未得到充分探索，这造成了当前认识上的空白。
分析了来自六个周期的美国国家健康与营养检查调查（NHANES，2005 - 2016年）的数据，包括6636名无糖尿病参与者。使用患者健康问卷-9（PHQ-9）评估抑郁症，得分5 - 9分和10 - 27分分别定义为轻度和中度至重度抑郁症。使用HOMA2-IR模型测量IR，IR定义为≥2.3的值。采用加权广义线性模型（GLMs）研究抑郁症与IR之间的关系。分层分析用于评估潜在的调节因素。
在调整人口统计学因素和代谢指标后，GLMs分析结果显示，中度至重度抑郁症显著增加了IR的几率（OR = 1.65，95%CI：1.04 - 2.61，p = 0.035），尤其是在非西班牙裔白人个体中（OR = 2.64，95%CI：1.39 - 5.00，p = 0.004）。使用抗抑郁药也降低了这种关联。
中度至重度抑郁症与IR显著相关，种族/民族和抗抑郁药的使用是重要的调节因素。这些发现强调了在高危人群中针对心理和代谢健康风险进行有针对性干预的必要性。
