Tan Lifei, Li Yan, Tan Ming, Gong Jing, Zhang Jinbiao
The 970th Hospital of the PLA Joint Logistic Support Force, Weihai, China.
Weihai Municipal Hospital Affiliated to Shandong University, Weihai, China.
J Diabetes Investig. 2025 Sep;16(9):1704-1712. doi: 10.1111/jdi.70097. Epub 2025 Jun 18.
This study aimed to examine the association between insulin resistance (IR) and post-stroke depression (PSD) occurrence in diabetic patients, providing novel insights for PSD prevention and treatment strategies.
Clinical data from 124 patients with acute cerebral infarction and diabetes mellitus were retrospectively analyzed. Based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), participants were stratified into two groups: an IR group (HOMA-IR > 2.69, n = 96) and a control group (HOMA-IR ≤ 2.69, n = 28). The occurrence of PSD was compared between the two groups by unadjusted analysis and inverse probability of treatment weighting (IPTW), and the correlation between HOMA-IR scores and PSD was analyzed by multivariate logistic regression.
At 3-month follow-up, the IR group exhibited significantly higher Hamilton Depression Scale (HAMD) scores (median 8 vs 6, P = 0.029) and a 3.28-fold increased PSD risk (OR = 3.28, 95% CI: 1.37-7.88, P = 0.006). After adjusting for baseline confounders using IPTW, the IR group maintained elevated PSD risk (adjusted OR = 2.64, P = 0.035). Multivariate analysis confirmed HOMA-IR as an independent PSD predictor (OR = 1.755, 95% CI: 1.360-2.263, P < 0.001), with ROC analysis demonstrating moderate predictive accuracy (AUC = 0.76, 51.4% sensitivity, 94.2% specificity at cutoff 5.2).
Elevated HOMA-IR levels in diabetic patients with acute cerebral infarction are significantly associated with increased PSD incidence.
本研究旨在探讨糖尿病患者胰岛素抵抗（IR）与卒中后抑郁（PSD）发生之间的关联，为PSD的预防和治疗策略提供新的见解。
回顾性分析124例急性脑梗死合并糖尿病患者的临床资料。根据胰岛素抵抗稳态模型评估（HOMA-IR），将参与者分为两组：IR组（HOMA-IR＞2.69，n = 96）和对照组（HOMA-IR≤2.69，n = 28）。通过未调整分析和治疗权重逆概率（IPTW）比较两组PSD的发生情况，并通过多因素逻辑回归分析HOMA-IR评分与PSD之间的相关性。
在3个月的随访中，IR组的汉密尔顿抑郁量表（HAMD）评分显著更高（中位数8对6，P = 0.029），PSD风险增加3.28倍（OR = 3.28，95%CI：1.37 - 7.88，P = 0.006）。使用IPTW调整基线混杂因素后，IR组的PSD风险仍然升高（调整后OR = 2.64，P = 0.035）。多因素分析证实HOMA-IR是PSD的独立预测因子（OR = 1.755，95%CI：1.360 - 2.263，P＜0.001），ROC分析显示预测准确性中等（AUC = 0.76，截断值为5.2时灵敏度为51.4%，特异性为94.2%）。
急性脑梗死糖尿病患者HOMA-IR水平升高与PSD发病率增加显著相关。
