Abstract
Abstract
Background
Major depressive disorder (MDD) is heterogeneous and immuno-metabolic dysregulation may underlie distinct symptom profiles. In this cross-sectional analysis, we examined associations between individual depressive symptoms and immuno-metabolic indices.
Methods
We analyzed 188 patients with MDD, integrating symptom profiles, immuno-metabolic indices, and demographic data. Three indices were constructed: an inflammatory index (high-sensitivity C-reactive protein), a metabolic index (BMI, glucose, triglycerides, and high-density lipoprotein cholesterol), and a combined immuno-metabolic index (sample sizes: inflammatory, n = 152; metabolic, n = 172; combined, n = 151). Univariable analyses (
P
P
FDR = 0.046). Anhedonia was positively associated with the metabolic index (β = 0.03,
P
FDR = 0.041), whereas decreased appetite was inversely associated with it (β = -0.15,
P
FDR = 0.041). Reverse analyses indicated that the metabolic and combined indices demonstrated stronger associations with anhedonia, whereas the inflammatory index showed a stronger association with decreased weight.
Conclusions
Immuno-metabolic alterations are differentially associated with depressive symptoms—particularly anhedonia and decreased appetite—in a Chinese population with MDD, suggesting distinct underlying biological mechanisms. These symptom-specific and BMI-dependent patterns underscore the heterogeneity of MDD and support a move toward symptom-informed stratification. Such an approach may facilitate the refinement of biologically informed, more homogeneous depression subtypes and advance precision treatment strategies.