Xia Xingzhi, Deng Hanxu, Ren Wei, Yang Lin, Zhu Yingzhao, Liu Yaozhi, Liu Junjun, Zhao Xueli, Jia Fengnan, Du Xiangdong, Zhang Xiangyang
Xuzhou Medical University, Xuzhou, China.
Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.
BMC Psychiatry. 2025 Jan 17;25(1):49. doi: 10.1186/s12888-025-06502-2.
Psychotic depression (PD) is a highly debilitating disorder characterized by hallucinations and/or delusions accompanied by depression. A variety of neurotransmitters, hormones and corresponding receptors in the endocrine system are involved in the onset and progression of depression, and fasting blood glucose (FBG) can be an important indicator for monitoring the stability of the endocrine system. The aim of this study was to investigate the relationship between FBG and PD in a Chinese population with first-episode drug-naïve (FEDN) major depressive disorder (MDD).
In this study, 1718 outpatient individuals diagnosed with first-episode drug-naïve major depressive disorder (FEDN MDD) were included. The association between PD and FBG levels was identified through multivariable binary logistic regression analysis. To investigate potential non-linear relationships, a two-piecewise linear regression model was utilized. Additionally, interaction and stratified analyses were performed based on gender, educational background, marital status, presence of comorbid anxiety, and history of suicide attempt.
Multivariate logistic regression analysis showed that FBG was positively associated with the risk of PD in FEDN MDD patients (OR = 1.68, 95% CI: 1.31 to 2.13; P < 0.05). Smoothed plots showed a non-linear relationship between FBG and PD, while the inflection point of FBG was calculated using a two-segmented logistic regression model to be 6.23 mmol/L. On the right side of the inflection point, the probability of PD increased substantially by 278% (OR = 3.78, 95% CI: 1.75 to 8.18, p < 0.001), while no significant association was observed on the left side of the inflection point (OR = 1.06, 95% CI: 0.73 to 1.52, p = 0.772).
Our investigation revealed a nonlinear relationship between FBG and PD in patients with FEDN MDD, thereby informing more effective intervention strategies for managing psychotic symptoms in individuals with depression.
精神病性抑郁症（PD）是一种高度致残的疾病，其特征为伴有抑郁的幻觉和/或妄想。内分泌系统中的多种神经递质、激素及相应受体参与了抑郁症的发病和进展，空腹血糖（FBG）可能是监测内分泌系统稳定性的重要指标。本研究旨在探讨中国首发未用药（FEDN）的重度抑郁症（MDD）患者中FBG与PD之间的关系。
本研究纳入了1718例诊断为首发未用药重度抑郁症（FEDN MDD）的门诊患者。通过多变量二元逻辑回归分析确定PD与FBG水平之间的关联。为研究潜在的非线性关系，采用了两段式线性回归模型。此外，还基于性别、教育背景、婚姻状况、共病焦虑的存在情况以及自杀未遂史进行了交互作用和分层分析。
多变量逻辑回归分析显示，FBG与FEDN MDD患者的PD风险呈正相关（OR = 1.68，95% CI：1.31至2.13；P < 0.05）。平滑图显示FBG与PD之间存在非线性关系，使用两段式逻辑回归模型计算出FBG的拐点为6.23 mmol/L。在拐点右侧，PD的概率大幅增加278%（OR = 3.78，95% CI：1.75至8.18，p < 0.001），而在拐点左侧未观察到显著关联（OR = 1.06，95% CI：0.73至1.52，p = 0.772）。
我们的研究揭示了FEDN MDD患者中FBG与PD之间的非线性关系，从而为管理抑郁症患者的精神病性症状提供了更有效的干预策略。
