Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorder

Abstract Introduction Psychotic depression (PD) is a highly debilitating disorder characterized by hallucinations and/or delusions accompanied by depression. A variety of neurotransmitters, hormones and corresponding receptors in the endocrine system are involved in the onset and progression of depr...

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Main Authors: Xingzhi Xia, Hanxu Deng, Wei Ren, Lin Yang, Yingzhao Zhu, Yaozhi Liu, Junjun Liu, Xueli Zhao, Fengnan Jia, Xiangdong Du, Xiangyang Zhang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06502-2
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author Xingzhi Xia
Hanxu Deng
Wei Ren
Lin Yang
Yingzhao Zhu
Yaozhi Liu
Junjun Liu
Xueli Zhao
Fengnan Jia
Xiangdong Du
Xiangyang Zhang
author_facet Xingzhi Xia
Hanxu Deng
Wei Ren
Lin Yang
Yingzhao Zhu
Yaozhi Liu
Junjun Liu
Xueli Zhao
Fengnan Jia
Xiangdong Du
Xiangyang Zhang
author_sort Xingzhi Xia
collection DOAJ
description Abstract Introduction Psychotic depression (PD) is a highly debilitating disorder characterized by hallucinations and/or delusions accompanied by depression. A variety of neurotransmitters, hormones and corresponding receptors in the endocrine system are involved in the onset and progression of depression, and fasting blood glucose (FBG) can be an important indicator for monitoring the stability of the endocrine system. The aim of this study was to investigate the relationship between FBG and PD in a Chinese population with first-episode drug-naïve (FEDN) major depressive disorder (MDD). Methods In this study, 1718 outpatient individuals diagnosed with first-episode drug-naïve major depressive disorder (FEDN MDD) were included. The association between PD and FBG levels was identified through multivariable binary logistic regression analysis. To investigate potential non-linear relationships, a two-piecewise linear regression model was utilized. Additionally, interaction and stratified analyses were performed based on gender, educational background, marital status, presence of comorbid anxiety, and history of suicide attempt. Results Multivariate logistic regression analysis showed that FBG was positively associated with the risk of PD in FEDN MDD patients (OR = 1.68, 95% CI: 1.31 to 2.13; P < 0.05). Smoothed plots showed a non-linear relationship between FBG and PD, while the inflection point of FBG was calculated using a two-segmented logistic regression model to be 6.23 mmol/L. On the right side of the inflection point, the probability of PD increased substantially by 278% (OR = 3.78, 95% CI: 1.75 to 8.18, p < 0.001), while no significant association was observed on the left side of the inflection point (OR = 1.06, 95% CI: 0.73 to 1.52, p = 0.772). Conclusions Our investigation revealed a nonlinear relationship between FBG and PD in patients with FEDN MDD, thereby informing more effective intervention strategies for managing psychotic symptoms in individuals with depression.
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spelling doaj-art-a216c5fd5782430e92cac8861bd255322025-01-26T12:46:36ZengBMCBMC Psychiatry1471-244X2025-01-0125111010.1186/s12888-025-06502-2Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorderXingzhi Xia0Hanxu Deng1Wei Ren2Lin Yang3Yingzhao Zhu4Yaozhi Liu5Junjun Liu6Xueli Zhao7Fengnan Jia8Xiangdong Du9Xiangyang Zhang10Xuzhou Medical UniversityXuzhou Medical UniversitySuzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow UniversitySuzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow UniversitySuzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow UniversitySuzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow UniversityNanjing Meishan HospitalSuzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow UniversitySuzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow UniversityXuzhou Medical UniversityCAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of SciencesAbstract Introduction Psychotic depression (PD) is a highly debilitating disorder characterized by hallucinations and/or delusions accompanied by depression. A variety of neurotransmitters, hormones and corresponding receptors in the endocrine system are involved in the onset and progression of depression, and fasting blood glucose (FBG) can be an important indicator for monitoring the stability of the endocrine system. The aim of this study was to investigate the relationship between FBG and PD in a Chinese population with first-episode drug-naïve (FEDN) major depressive disorder (MDD). Methods In this study, 1718 outpatient individuals diagnosed with first-episode drug-naïve major depressive disorder (FEDN MDD) were included. The association between PD and FBG levels was identified through multivariable binary logistic regression analysis. To investigate potential non-linear relationships, a two-piecewise linear regression model was utilized. Additionally, interaction and stratified analyses were performed based on gender, educational background, marital status, presence of comorbid anxiety, and history of suicide attempt. Results Multivariate logistic regression analysis showed that FBG was positively associated with the risk of PD in FEDN MDD patients (OR = 1.68, 95% CI: 1.31 to 2.13; P < 0.05). Smoothed plots showed a non-linear relationship between FBG and PD, while the inflection point of FBG was calculated using a two-segmented logistic regression model to be 6.23 mmol/L. On the right side of the inflection point, the probability of PD increased substantially by 278% (OR = 3.78, 95% CI: 1.75 to 8.18, p < 0.001), while no significant association was observed on the left side of the inflection point (OR = 1.06, 95% CI: 0.73 to 1.52, p = 0.772). Conclusions Our investigation revealed a nonlinear relationship between FBG and PD in patients with FEDN MDD, thereby informing more effective intervention strategies for managing psychotic symptoms in individuals with depression.https://doi.org/10.1186/s12888-025-06502-2Major depressive disorderFasting blood glucose (FBG)Psychotic symptomFirst episodeDrug naïve
spellingShingle Xingzhi Xia
Hanxu Deng
Wei Ren
Lin Yang
Yingzhao Zhu
Yaozhi Liu
Junjun Liu
Xueli Zhao
Fengnan Jia
Xiangdong Du
Xiangyang Zhang
Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorder
BMC Psychiatry
Major depressive disorder
Fasting blood glucose (FBG)
Psychotic symptom
First episode
Drug naïve
title Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorder
title_full Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorder
title_fullStr Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorder
title_full_unstemmed Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorder
title_short Association between fasting blood glucose and psychotic symptoms in Chinese patients with first-episode drug-naïve major depressive disorder
title_sort association between fasting blood glucose and psychotic symptoms in chinese patients with first episode drug naive major depressive disorder
topic Major depressive disorder
Fasting blood glucose (FBG)
Psychotic symptom
First episode
Drug naïve
url https://doi.org/10.1186/s12888-025-06502-2
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