体重指数和腰围在抑郁症与2型糖尿病患病风险中的中介效应OA

Objective:To investigate the potential mediating effects of body mass index(BMI)and waist circumference on the association between depression and the risk of type 2 diabetes mellitus(T2DM)in adults.The findings will provide valuable insights for the prevention and control of diabetes.Methods:This cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey between 2011 and 2018.A total of 20 576 adults aged 18 years and older were enrolled.Participants were classified into two groups according to patient health questionnaire-9(PHQ-9)scores:PHQ-9<10 group and PHQ-9≥10 group,and further stratified by BMI and waist circumference.Multivariate Logistic regression and restricted cubic splines were used to explore the dose-response relationship between depressive symptoms and T2DM risk.The sequential test method was applied to analyze the mediating effects of BMI and waist circumference on the association between depression and T2DM risk.Results:Participants with PHQ-9 score≥10 had significantly higher prevalence of T2DM,fasting plasma glucose(FPG),and glycated hemoglobin(HbA1c)levels than those with PHQ-9 score<10(all P<0.01).The risk of T2DM increased progressively with higher PHQ-9 scores(all P<0.01).Mediation analysis revealed that the mediating proportions of BMI in the associations between PHQ-9 score and T2DM risk,FPG,and HbA1c were 21.82%,27.03%,and 34.87%,respectively;those of waist circumference were 21.82%,34.71%,and 42.76%,respectively(all P<0.01).Conclusion:Depressive symptoms are significantly associated with the risk of T2DM,and the risk increases with the severity of depression.BMI and waist circumference play important mediating roles in this association.Therefore,for overweight or obese patients with depression,greater attention should be paid to the prevention and management of T2DM.