Impact of insulin resistance on post-stroke depression and outcomes in diabetes.

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-06-18 DOI:10.1111/jdi.70097

Lifei Tan, Yan Li, Ming Tan, Jing Gong, Jinbiao Zhang

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Abstract

Aims: This study aimed to examine the association between insulin resistance (IR) and post-stroke depression (PSD) occurrence in diabetic patients, providing novel insights for PSD prevention and treatment strategies.

Materials and methods: Clinical data from 124 patients with acute cerebral infarction and diabetes mellitus were retrospectively analyzed. Based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), participants were stratified into two groups: an IR group (HOMA-IR > 2.69, n = 96) and a control group (HOMA-IR ≤ 2.69, n = 28). The occurrence of PSD was compared between the two groups by unadjusted analysis and inverse probability of treatment weighting (IPTW), and the correlation between HOMA-IR scores and PSD was analyzed by multivariate logistic regression.

Results: At 3-month follow-up, the IR group exhibited significantly higher Hamilton Depression Scale (HAMD) scores (median 8 vs 6, P = 0.029) and a 3.28-fold increased PSD risk (OR = 3.28, 95% CI: 1.37-7.88, P = 0.006). After adjusting for baseline confounders using IPTW, the IR group maintained elevated PSD risk (adjusted OR = 2.64, P = 0.035). Multivariate analysis confirmed HOMA-IR as an independent PSD predictor (OR = 1.755, 95% CI: 1.360-2.263, P < 0.001), with ROC analysis demonstrating moderate predictive accuracy (AUC = 0.76, 51.4% sensitivity, 94.2% specificity at cutoff 5.2).

Conclusions: Elevated HOMA-IR levels in diabetic patients with acute cerebral infarction are significantly associated with increased PSD incidence.

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胰岛素抵抗对卒中后抑郁和糖尿病预后的影响。

目的：本研究旨在探讨胰岛素抵抗（IR）与糖尿病患者脑卒中后抑郁（PSD）发生的关系，为PSD的预防和治疗策略提供新的见解。材料与方法：回顾性分析124例急性脑梗死合并糖尿病患者的临床资料。根据胰岛素抵抗的稳态模型评估（HOMA-IR），参与者被分为两组：胰岛素抵抗组（HOMA-IR bb0 2.69, n = 96）和对照组（HOMA-IR≤2.69,n = 28）。采用未校正分析和治疗加权逆概率（IPTW）比较两组患者PSD的发生情况，采用多因素logistic回归分析HOMA-IR评分与PSD的相关性。结果：在3个月的随访中，IR组表现出明显更高的汉密尔顿抑郁量表（HAMD）得分（中位数8比6，P = 0.029）， PSD风险增加3.28倍（OR = 3.28, 95% CI: 1.37-7.88, P = 0.006）。在使用IPTW调整基线混杂因素后，IR组PSD风险保持升高（调整后OR = 2.64, P = 0.035）。多因素分析证实HOMA-IR是独立的PSD预测因子（OR = 1.755, 95% CI: 1.360-2.263， P）。结论：糖尿病合并急性脑梗死患者HOMA-IR水平升高与PSD发病率增加显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Investigation Medicine-Internal Medicine

自引率

9.40%

发文量

218

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).