The relationship between depression and insulin resistance in the population without diabetes: Results from the 2005–2016 NHANES

Background

Insulin resistance (IR), a precursor of type 2 diabetes and other metabolic disorders, is becoming more common owing to rising obesity rates. Depression, which affects 4.4 % of the global population, has been linked to IR; however, the findings are inconsistent. The roles of moderating factors in the depression-IR relationship remain underexplored, creating a gap in the current understanding.

Methods

Data from six cycles of the National Health and Nutrition Examination Survey (NHANES, 2005–2016), including 6636 participants without diabetes, were analyzed. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores of 5–9 and 10–27 defined as mild and moderate-to-severe depression, respectively. IR was measured using the HOMA2-IR model, with IR defined as a value of ≥ 2.3. Weighted generalized linear models (GLMs) were used to investigate the relationship between depression and IR. Stratified analyses were used to evaluate the potential moderators.

Results

After adjusting for demographic factors and metabolic indicators, the results of GLMs analysis showed that moderate-to-severe depression significantly increased the odds of IR (OR = 1.65, 95 % CI: 1.04–2.61, p = 0.035), especially in non-Hispanic White individuals (OR = 2.64, 95 % CI: 1.39–5.00, p = 0.004). Antidepressant use also reduced this association.

Conclusion

Moderate-to-severe depression was significantly associated with IR, and race/ethnicity and antidepressant use were important moderators. These findings underscore the need for targeted interventions to address both mental and metabolic health risks in high-risk populations.