实用临床医药杂志2026，Vol.30Issue(15)：8-14,21,8.DOI:10.7619/jcmp.20263030
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
Associations of low muscle mass phenotype and insulin resistance indicators with depressive symptoms:a study based on the NHANES database
摘要
Abstract
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.关键词
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Key words
low muscle mass phenotype/appendicular lean mass/depressive symptoms/home-ostatic model assessment of insulin resistance/triglyceride-glucose index/high-density lipoprotein cholesterol/triglyceride/National Health and Nutrition Examination Survey分类
医药卫生引用本文复制引用
苏纭瑶,姚俊杰,孙雅蕙,丛德毓,雷龙鸣,杨宇..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[J].实用临床医药杂志,2026,30(15):8-14,21,8.基金项目
国家自然科学基金面上项目(82274673) （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) （桂科发[2025]293号）
广西科技计划项目资助(桂科LT2600640073) （桂科LT2600640073）
