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. 2023 Sep 25;13(1):16033.
doi: 10.1038/s41598-023-43166-y.

Gender differences in the association between body mass index and recent suicide attempts in Chinese patients with first-episode drug-naïve major depressive disorder

Junjun Liu #  1   2   3 , Zhe Li #  2 , Fengnan Jia #  2   3 , Hsinsung Yuan  1 , Yue Zhou  2   4 , Xingzhi Xia  2   4 , Ruchang Yang  2   3 , Yuxuan Wu  2   3 , Xiaobin Zhang  2 , Gang Ye  2 , Xiangdong Du  5   6 , Xiangyang Zhang  7
Affiliations

Gender differences in the association between body mass index and recent suicide attempts in Chinese patients with first-episode drug-naïve major depressive disorder

Junjun Liu et al. Sci Rep. .

Abstract

Controversial evidence exists on the relationship between body mass index (BMI) and suicide attempts (SA) in patients with major depressive disorder (MDD). This cross-sectional study aimed to explore the association between BMI and SA in first-episode drug-naïve (FEDN) MDD patients in China. The study was conducted from 2016 to 2018 in Taiyuan, China. Univariate and multivariate logistic regression analyzed the BMI-SA association, with subgroup analysis for gender. Threshold effects were examined using two-piecewise regression. In males, BMI was significantly associated with SA (OR = 0.84, 95% CI 0.74-0.94, P = 0.003) after full adjustment, but not in females (OR = 0.97, 95% CI 0.89-1.06, P = 0.541). The interaction with gender was significant (P for interaction < 0.05). Smoothing plots revealed an L-shaped BMI-SA relationship in both genders, with BMI inflection points at 27.3 kg/m2 in males and 21.4 kg/m2 in females. Below the inflection points, BMI is negatively associated with SA in males (OR = 0.75, 95% CI 0.66-0.86, P < 0.001) and females (OR = 0.48, 95% CI 0.32-0.72, P < 0.001). Above the inflection points, no association existed for both genders (all P > 0.05). Results showed an L-shaped nonlinear BMI-SA relationship in FEDN MDD patients but differing BMI inflection points between genders, thus contributing to effective prevention programs for suicide.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of this study.
Figure 2
Figure 2
Association between BMI and SA in different gender of patients with FEDN MDD. A non-linear association between BMI and SA was found in the multivariable logistic regression model in both male and female patients (all P for non-linearity < 0.05). All adjusted for age at onset, duration of illness, education, HAMA, HAMD, TSH, TGAb, TPOAb, FBG, TC, TG, HDL-c, TG, LDL-c, systolic pressure, diastolic pressure.
Figure 3
Figure 3
Stratified and interaction analyses of the association between BMI and SA. The OR (95% CI) was derived from the Logistic regression model. (Age at onset, duration of illness, HAMA, HAMD, TSH, TGAb, TPOAb, FBG, TC, TG, HDL-c, TG, LDL-c, SBP and DBP were adjusted).
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