Chen Shiwang, Zhou Jianan, Lang XiaoE, Zhang Xiang-Yang
Institute of Mental Health, Tianjin Anding Hospital, Tianjin, China.
Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.
Eur Arch Psychiatry Clin Neurosci. 2025 Feb 25. doi: 10.1007/s00406-025-01980-7.
Gender differences in glucose metabolism disorders in patients with major depressive disorder (MDD) have been rarely studied. In this study we investigated gender differences in the prevalence of glucose metabolism disorders and associated factors in first-episode and drug naïve (FEDN) MDD patients in a Chinese Han population. In this cross-sectional study, a total of 1718 FEDN MDD outpatients were recruited, and demographic and clinical data were collected. All subjects were scored using the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and the Positive and Negative Syndrome Scale (PANSS) positive subscale to assess clinical symptoms. Female MDD patients were older, present with symptoms at an older age, were more likely to be married and had more psychotic symptoms than male MDD patients. There was no significant difference in the prevalence of glucose metabolism disorders between female patients (14.16%) and male patients (12.59%) (p > 0.05). In both male and female groups, patients with glucose metabolism disorders had higher HAMD score, HAMA score, suicide attempts, and psychotic symptoms than patients without glucose metabolism disorders (all p < 0.05). However, only in female group, patients with glucose metabolism disorders had more severe anxiety symptoms than patients without glucose metabolism disorders. Furthermore, binary logistic regression analysis showed that psychotic symptoms and suicide attempts were independently associated with glucose metabolism disorders in male MDD patients, while suicide attempts and HAMD score was independently associated with glucose metabolism disorders in female MDD patients. Our findings showed no gender differences in the prevalence of glucose metabolism disorders in patients with FEDN MDD. However, there were gender difference in the clinical correlates of glucose metabolism disorders in FEDN MDD patients.
重度抑郁症(MDD)患者糖代谢紊乱的性别差异鲜有研究。在本研究中,我们调查了中国汉族人群中首发且未用药的(FEDN)MDD患者糖代谢紊乱患病率及相关因素的性别差异。在这项横断面研究中,共招募了1718例FEDN MDD门诊患者,并收集了人口统计学和临床数据。所有受试者均使用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和阳性与阴性症状量表(PANSS)阳性分量表进行评分,以评估临床症状。女性MDD患者比男性MDD患者年龄更大,起病年龄更大,更有可能已婚,且有更多的精神病性症状。女性患者(14.16%)和男性患者(12.59%)的糖代谢紊乱患病率无显著差异(p>0.05)。在男性和女性组中,糖代谢紊乱患者的HAMD评分、HAMA评分、自杀未遂及精神病性症状均高于无糖代谢紊乱的患者(所有p<0.05)。然而,仅在女性组中,糖代谢紊乱患者的焦虑症状比无糖代谢紊乱的患者更严重。此外,二元逻辑回归分析显示,精神病性症状和自杀未遂与男性MDD患者的糖代谢紊乱独立相关,而自杀未遂和HAMD评分与女性MDD患者的糖代谢紊乱独立相关。我们的研究结果显示,FEDN MDD患者的糖代谢紊乱患病率无性别差异。然而,FEDN MDD患者糖代谢紊乱的临床相关因素存在性别差异。