Insulin resistance as a marker for the immune-metabolic subtype of depression

JOURNAL OF AFFECTIVE DISORDERS

卷:295

Article

Brouwer, Annelies^1,2,3  van Raalte, Daniel H.⁴  Lamers, Femke^1,2,3  Rutters, Femke⁵  Elders, Petra J. M.⁶  Van Someren, Eus J. W.^1,2,3,7,8  Snoek, Frank J.^9,10  Beekman, Aartjan T. F.^1,2,3  Bremmer, Marijke A.^1,2,3 

[1] Vrije Univ, Amsterdam Publ Hlth Res Inst, Amsterdam UMC, Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands

[2] Vrije Univ, Amsterdam Publ Hlth Res Inst, Dept Psychiat, GGZ InGeest, Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands

[3] Postbus 7075, NL-1007 MB Amsterdam, Netherlands

[4] Vrije Univ, Diabet Ctr, Dept Internal Med, Amsterdam UMC, Amsterdam, Netherlands

[5] Vrije Univ, Amsterdam Publ Hlth Res Inst, Dept Epidemiol & Biostat, Amsterdam UMC, Amsterdam, Netherlands

[6] Vrije Univ, Amsterdam Publ Hlth Res Inst, Dept Gen Practice & Elderly Care Med, Amsterdam UMC, Amsterdam, Netherlands

[7] Netherlands Inst Neurosci, Dept Sleep & Cognit, Amsterdam, Netherlands

[8] Vrije Univ, Ctr Neurogen & Cognit Res, Dept Integrat Neurophysiol, Amsterdam UMC, Neurosci Campus Amsterdam, Amsterdam, Netherlands

[9] Vrije Univ, Amsterdam Publ Hlth Res Inst, Dept Med Psychol, Amsterdam UMC, Amsterdam, Netherlands

[10] Univ Amsterdam, Amsterdam, Netherlands

关键词: Depression;    Insulin resistance;    Subtype;    Diabetes;    Light therapy;   

DOI  :  10.1016/j.jad.2021.08.151

来源: Elsevier

【 摘 要 】

Objective: Insulin resistance (IR), a marker of metabolic dysregulation and pro-inflammatory state, moderates the antidepressant treatment effect in patients with type 2 diabetes (T2D) and is therefore a potential marker for personalized treatment. Based on data from a light therapy trial (NTR4942), we aimed to evaluate whether 1) depression symptoms differ according to the level of IR, and 2) improvement of specific depression symptoms drive the positive effects of light therapy in those with higher IR. Methods: This secondary analysis in 59 individuals with depression and T2D explored differences in depressive symptom profile (30-item Inventory of Depressive Symptomatology (IDS)) at baseline and in response to light therapy (versus placebo), between lower and higher IR individuals, using Likelihood Ratio tests and Linear-bylinear association. IR was measured using the gold standard, a hyperinsulinemic-euglycaemic clamp. Results: At baseline, higher IR individuals reported more symptoms of irritability (p=0.024) anhedonia (no interest in people and activities: p=0.011; absence of pleasure and enjoyment: p=0.021), fatigue (fatigue: p=0.036; physical fatigue: p=0.035) and hypersomnia (p=0.029) relative to persons with lower IR, who reported more insomnia (nightly awakening: p=0.041; early morning awakening: p=0.012). Light therapy led to an improvement across IDS symptoms in higher IR individuals, while in lower IR individuals, light therapy improved early morning awakening (p=0.005) and interest in people and activities (p=0.015), but worsened mood (feeling sad: p=0.001; feeling irritable: p=0.002; interpersonal sensitivity: p=0.014). Conclusions: Results add to the hypothesis of an immune-metabolic subtype of depression, and suggest that IR might be a promising focus for precision medicine.

【 授权许可】

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