抑郁症患者体质量指数和代谢综合征转移规律研究  

Transition of body mass index and metabolic syndrome in patients with major depressive disorder

作　　者：齐涵 董程程 刘瑞 朱雪泉[1,2] 蔺煦舟 秦妍舒 于子博 王海宁 李蕾[4] 冯媛[1,2] 张玲[1,2] 闫芳[1,2] Qi Han;Dong Chengcheng;Liu Rui;Zhu Xuequan;Lin Xuzhou;Qin Yanshu;Yu Zibo;Wang Haining;Li Lei;Feng Yuan;Zhang Ling;Yan Fang(Beijing Key Laboratory of Mental Disorders,National Clinical Research Center for Mental Disorders&National Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China;Department of Endocrinology and Metabolic Disease,Peking University Third Hospital,Beijing 100191,China;Department of Cardiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]首都医科大学附属北京安定医院国家精神疾病医学中心国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室,北京100088 [2]首都医科大学人脑保护高精尖创新中心,北京100069 [3]北京大学第三医院内分泌科,北京100191 [4]北京大学第三医院心内科,北京100191

出　　处：《首都医科大学学报》2025年第2期202-209,共8页Journal of Capital Medical University

基　　金：北京市卫生健康委高层次公共卫生人才学科带头人项目(xuekedaitouren-01-30);北京市医院管理中心青年人才培养“青苗”计划项目(QML20231905)。

摘　　要：目的评估抑郁症患者中体质量指数(body mass index,BMI)正常、超重和代谢综合征(metabolic syndrome,MetS)的转移规律。方法以2016年1月至2021年11月期间于首都医科大学附属北京安定医院治疗,有多次入院记录的抑郁症患者为研究对象,根据每次入院时BMI和代谢情况分为BMI正常、超重和代谢综合征3种状态,采用多状态Markov模型分析转移规律。结果纳入398例研究对象的892条观测记录,中位年龄56岁,中位随访时间40个月。结果显示3种状态间共发生494次转移,其中5.1%由BMI正常转移为超重,5.5%由超重转移为MetS。超重发展为MetS的转移强度最高,是超重变为BMI正常的9.52倍。48.53个月后,BMI正常的抑郁症患者开始转移为MetS。对于超重的患者,8.77个月后开始转移为MetS。36个月后,BMI正常或超重者转移为MetS的概率为31.4%和50.4%;对于合并MetS者,36个月后仍为MetS的概率为51.2%。多因素分析显示未婚是体质量正常的抑郁症患者转移为超重的危险因素,而具有较高的受教育程度是超重的抑郁症患者转移为MetS的保护因素。结论抑郁症患者发展为MetS的强度和风险较高,发生MetS后不易好转,提示加强抑郁症患者的BMI管理和MetS的干预。Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4%males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1%moved from normal BMI to overweight and 5.5%moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4%and 50.4%probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2%after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.

关 键 词：重性抑郁障碍 代谢综合征 体质量指数 超重 多状态MARKOV模型 转移规律 

分 类 号：R749[医药卫生—神经病学与精神病学]