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重度抑郁症门诊患者中肌肉减少症与代谢综合征的高患病率及其临床相关性:一项横断面研究

High Prevalence and Clinical Correlates of Sarcopenia and Metabolic Syndrome in Outpatients with Major Depressive Disorder: A Cross-Sectional Study.

作者信息

Hung Ching-I, Wang Le-Yung, Lin Huang-Li, Yang Ching-Hui

机构信息

Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.

Chang Gung University College of Medicine, Taoyuan, Taiwan.

出版信息

Neuropsychiatr Dis Treat. 2025 Sep 11;21:2053-2065. doi: 10.2147/NDT.S537505. eCollection 2025.

Abstract

OBJECTIVE

This study aimed to investigate the percentages, clinical characteristics, and risk factors of sarcopenia and metabolic syndrome (MetS) among outpatients with major depressive disorder (MDD).

METHODS

This study enrolled 225 MDD outpatients based on DSM-V and age- and sex-matched health controls (HCs). Sarcopenia was diagnosed based on the 2019 Asian Working Group for Sarcopenia diagnostic criteria. Three psychometric scales and the Montreal Cognitive Assessment were used to evaluate the severities of depression, anxiety, and somatic symptoms and cognitive function, respectively. Binary logistic regression models were used to investigate the risk factors of the two disorders.

RESULTS

MDD subjects had significantly higher percentages of sarcopenia (41.3% vs 15.6%), MetS (40.9% vs 28.9%), and sarcopenia and/or MetS (68.9% vs 40.4%) than HCs. For elderly MDD subjects, 89.3% suffered from sarcopenia and/or MetS. MDD subjects had higher unqualified percentages in handgrip strength and three physical performance tests than HCs. MDD subjects with sarcopenia had worse depression than those without. MDD subjects with MetS had poorer cognitive function than those without. MDD subjects with only sarcopenia had worse mood symptoms than those with only MetS. After controlling for age and other variables, full remission of depression decreased the risk of sarcopenia. Being overweight decreased and increased the risk of sarcopenia and MetS, respectively.

CONCLUSIONS

Most MDD outpatients, especially elderly outpatients, suffered from sarcopenia and/or MetS. The two disorders should be screened in MDD patients. Treatment of depression might decrease the risk of sarcopenia.

摘要

目的

本研究旨在调查重度抑郁症(MDD)门诊患者中肌肉减少症和代谢综合征(MetS)的发生率、临床特征及危险因素。

方法

本研究纳入了225例符合DSM - V标准的MDD门诊患者以及年龄和性别匹配的健康对照者(HCs)。根据2019年亚洲肌肉减少症工作组的诊断标准诊断肌肉减少症。分别使用三种心理测量量表和蒙特利尔认知评估量表来评估抑郁、焦虑和躯体症状的严重程度以及认知功能。采用二元逻辑回归模型研究这两种疾病的危险因素。

结果

与HCs相比,MDD患者的肌肉减少症(41.3%对15.6%)、MetS(40.9%对28.9%)以及肌肉减少症和/或MetS(68.9%对40.4%)的发生率显著更高。对于老年MDD患者,89.3%患有肌肉减少症和/或MetS。MDD患者在握力和三项身体机能测试中的不合格率高于HCs。患有肌肉减少症的MDD患者的抑郁程度比未患肌肉减少症的患者更严重。患有MetS的MDD患者的认知功能比未患MetS的患者更差。仅患有肌肉减少症的MDD患者的情绪症状比仅患有MetS的患者更差。在控制年龄和其他变量后,抑郁症的完全缓解降低了肌肉减少症的风险。超重分别降低和增加了肌肉减少症和MetS的风险。

结论

大多数MDD门诊患者,尤其是老年门诊患者,患有肌肉减少症和/或MetS。应在MDD患者中筛查这两种疾病。抑郁症的治疗可能会降低肌肉减少症的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf9b/12435523/db659b55b87e/NDT-21-2053-g0001.jpg

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