| Objective To investigate the evaluation value of visceral fat index(VAI)in women with comorbid metabolic syndrome(MS),and to further analyze the heterogeneity of clinical manifestations in women with comorbid MS.Methods A total of 120 female patients with depression who met the ICD-10 diagnostic criteria and were hospitalized in Kailuan Mental Health Center from December 2018 to August 2019 were collected.According to the diagnostic criteria of MS,female patients with depression were divided into comorbid MS(MS group,31)and non-comorbid MS(non-MS group,89).Hamilton depression scale(HAMD-24)was used to evaluate the depression of patients.Anthropometric and laboratory indicators were collected,and VAI values were calculated according to waist circumference(WC),body mass index(BMI),triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C).The difference of VAI level between MS group and non-MS group was analyzed.Further,according to the third quantile of VAI value,female patients with depression were divided into three groups(high VAI group,medium VAI group and low VAI group).Differences in laboratory and anthropometric indicators among the three groups were compared,and the correlation between each index and VAI was analyzed.The ROC curve was drawn to analyze the evaluation value of VAI to MS.The differences of HAMD factors between MS group and non-MS group were further analyzed.Results 1 The VAI level of the MS group was significantly higher than that of the nonMS group,and the difference was statistically significant(P<0.05).2 VAI was positively correlated with WC,TG and FPG(r=0.305,0.900,0.278,P<0.01),positively correlated with SBP and DBP(r=0.183,0.205,P<0.05),and negatively correlated with HDL-C(r=-0.599,P<0.01).3 Stepwise multiple regression analysis revealed that WC,TG and depression severity were risk factors for VAI,and HDL-C was a protective factor for VAI.4 ROC curve analysis showed that the maximum area under the VAI curve(AUC)was 0.883(95% CI(0.823,0.942),P<0.001).Compared with WC,BMI,WHt R,and WHR,VAI was the best index to evaluate comorbidities of depression in women.The optimal critical value for VAI to evaluate comorbidity MS in female depression was 3.578,with a sensitivity of 0.968 and specificity of 0.798.5 The mean scores of anxiety / somatization,cognitive disorders,sleep disorders,retardation factors and HAMD scores in the MS group were higher than those in the non-MS group,with statistically significant differences(P<0.05).6 The severity coefficients of sleep disorder,anxiety / somatization,retardation and cognitive disorder were higher in the MS group,which were 0.731,0.692,0.684 and 0.606,respectively.The severity coefficients of hopelessness,weight and anxiety / somatization were 0.645,0.629 and 0.611,respectively,in the non-MS group.7 VAI was positively correlated with anxiety / somalization,cognitive disorders,and retardation factors(r=0.186,0.215,0.176,P<0.01),and was positively correlated with total HAMD scores(r=0.152,P<0.05),but not with weight,day and night changes,sleep disorders,and depression factors(P>0.05).Conclusion 1 VAI can be used as women during depression comorbidity screening and evaluation index of MS,VAI assessment during female depression comorbidity MS best critical value of 3.578,and WC,TG and severity of the depression is VAI increased risk factors,during the treatment of patients with depression in women should be paid attention to during the process of the change of the WC and TG,early intervention,to reduce the accumulation of visceral fat,thus effectively reduce the incidence of female depression patients with MS.2 There is heterogeneity in clinical manifestations between female MS patients with depressive comorbidities and patients with depression.Comorbidities are mainly characterized by anxiety / somatization,cognitive disorder,sleep disorder and delayed symptoms.Early identification and individualized treatment plan should be paid attention to in clinical work to promote patients' recovery.Figure.2;Table12;Reference 191... |
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