Insulin resistance and poorer treatment outcomes in depression: evidence from UK Biobank primary care data

作者：Giuseppe Fanelli, Janita Bralten, Barbara Franke, Nina Roth Mota, Anna Rita Atti, Diana De Ronchi, Alessio Maria Monteleone, Luigi Grassi, MNESYS – Mood and Psychosis Sub-Project (Spoke 5), Alessandro Serretti, Chiara Fabbri · 发表于：The British Journal of Psychiatry · 年份：2025 · DOI：10.1192/bjp.2025.82 · 被引用次数：8 · 研究领域：Cardiac Health and Mental Health、Tryptophan and brain disorders、Genetic Associations and Epidemiology

BACKGROUND: Major depressive disorder (MDD) and insulin resistance-related conditions are major contributors to global disability. Their co-occurrence complicates clinical outcomes, increasing mortality and symptom severity. AIMS: In this study, we investigated the association of insulin resistance-related conditions and related polygenic scores (PGSs) with MDD clinical profile and treatment outcomes, using primary care records from UK Biobank. METHOD: We identified MDD cases and insulin resistance-related conditions, as well as measures of depression treatment outcomes (e.g. resistance) from the records. Clinical-demographic variables were derived from self-reports, and insulin resistance-related PGSs were calculated using PRS-CS. Univariable analyses were conducted to compare sociodemographic and clinical variables of MDD cases with (IR+) and without (IR-) lifetime insulin resistance-related conditions. Multiple regressions were performed to identify factors, including insulin resistance-related PGSs, potentially associated with treatment outcomes, adjusting for confounders. RESULTS: < 0.001). IR+ participants showed distinctive depressive profiles, characterised by concentration issues, loneliness and inadequacy feelings, which varied according to the timing of MDD diagnosis relative to insulin resistance-related conditions. After adjusting for confounders, insulin resistance-related conditions (i.e. cardiovascular diseases, hypertension, non-alcoholic fatty liver disease,...