基于NHANES数据库的低肌肉量表型、胰岛素抵抗指标与抑郁症状的关联研究OA
Associations of low muscle mass phenotype and insulin resistance indicators with depressive symptoms:a study based on the NHANES database
目的 探讨基于附肢瘦体质量与体质量指数比值(ALM/BMI)定义的低肌肉量表型与抑郁症状的关联,并分析胰岛素抵抗相关指标在二者关联中的统计解释作用.方法 纳入2011-2018年美国国家健康与营养调查(NHANES)数据库中资料完整者3 666例.根据ALM/BMI性别特异性阈值定义低肌肉量表型.采用患者健康问卷-9(PHQ-9)评估抑郁症状,以PHQ-9总分≥10分定义存在抑郁症状.计算甘油三酯-葡萄糖指数(TyG)、胰岛素抵抗指数(HOMA-IR)及甘油三酯(TG)与高密度脂蛋白胆固醇(HDL-C)比值.采用复杂抽样加权多变量Logistic回归分析,评估低肌肉量表型、胰岛素抵抗相关指标与抑郁症状的关联;并进一步开展探索性统计关联分析.结果 调整潜在混杂因素后,低肌肉量表型与抑郁症状发生风险升高显著相关(OR=1.77,95％CI:1.18～2.66,P=0.009).TyG、HOMA-IR及TG/HDL-C与低肌肉量表型风险升高存在统计学关联,趋势检验均有统计学意义(P趋势＜0.001).在胰岛素抵抗相关指标与抑郁症状的关联分析中,仅TyG最高四分位数组在完全调整后仍与抑郁症状发生风险升高相关(OR=1.61,95％CI:1.07～2.41,P=0.028),且趋势检验有统计学意义(P趋势=0.017).探索性统计关联分解显示,TyG、TG/HDL-C和HOMA-IR分别解释总关联的8.91％、5.38％和3.32％.结论 低肌肉量表型与抑郁风险显著相关.TyG、HOMA-IR及TG/HDL-C均与低肌肉量表型相关,其中TyG关联最稳健.胰岛素抵抗指标在二者间起部分中介作用.
Objective To investigate the association between low muscle mass phenotype,defined by appendicular lean mass/body mass index(ALM/BMI),and depressive symptoms,and to analyze the statistical explanatory role of insulin resistance-related indicators in this association.Methods A total of 3 666 participants with complete data were enrolled from the National Health and Nutrition Ex-amination Survey(NHANES)database(2011 to 2018).Low muscle mass phenotype was defined based on sex-specific thresholds of ALM/BMI.Depressive symptoms were assessed using the Patient Health Questionnaire-9(PHQ-9),with a total score≥10 indicating the presence of depressive symptoms.The triglyceride-glucose(TyG)index,homeostatic model assessment of insulin resistance(HOMA-IR)and triglyceride/high-density lipoprotein cholesterol(TG/HDL-C)were calculated.Weighted multi-variable logistic regression analyses for complex sampling were performed to evaluate the associations of low muscle mass phenotype and insulin resistance-related indicators with depressive symptoms.An exploratory statistical correlation analysis was further conducted.Results After adjusting for potential confounders,low muscle mass phenotype was significantly associated with an increased risk of depres-sive symptoms(OR=1.77,95％CI:1.18-2.66,P=0.009).TyG,HOMA-IR and TG/HDL-C were statistically associated with an increased risk of low muscle mass phenotype,with significant trends(Pfor trend＜0.001).In the association analysis between insulin resistance-related indicators and depressive symptoms,only the highest quartile of TyG remained significantly associated with an increased risk of depressive symptoms after full adjustment(OR=1.61,95％CI:1.07-2.41,P=0.028),with a significant trend(Pfortrend=0.017).The exploratory statistical pathway decom-position analysis revealed that TyG,TG/HDL-C and HOMA-IR accounted for 8.91％,5.38％and 3.32％of the total association,respectively.Conclusions Low muscle mass phenotype is signifi-cantly associated with the risk of depressive symptoms.TyG,HOMA-IR,and TG/HDL-C are all as-sociated with low muscle mass phenotype,with TyG demonstrating the most robust association.Insu-lin resistance indicators partially mediate the relationship between two conditions.
苏纭瑶;姚俊杰;孙雅蕙;丛德毓;雷龙鸣;杨宇
广西中医药大学,广西南宁,530200中国中医科学院广安门医院,北京,100000长春中医药大学附属医院,吉林长春,130021长春中医药大学附属医院,吉林长春,130021广西中医药大学第一附属医院,广西南宁,530023广西中医药大学第一附属医院,广西南宁,530023
医药卫生
低肌肉量表型附肢瘦体质量抑郁症状胰岛素抵抗指数甘油三酯-葡萄糖指数高密度脂蛋白胆固醇甘油三酯美国国家健康与营养调查
low muscle mass phenotypeappendicular lean massdepressive symptomshome-ostatic model assessment of insulin resistancetriglyceride-glucose indexhigh-density lipoprotein cholesteroltriglycerideNational Health and Nutrition Examination Survey
《实用临床医药杂志》 2026 (15)
8-14,21,8
国家自然科学基金面上项目(82274673)广西临床医学研究中心"广西中医康复临床医学研究中心"建设项目(桂科发[2025]293号)广西科技计划项目资助(桂科LT2600640073)
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