Sex-Specific Elevated Fasting Glucose in Patients with Major Depressive Disorder.

Background: This study aimed to test whether the relationship between Major Depressive Disorder (MDD) and prediabetes is sex-specific and explored potential pathways. Methods: One hundred sixty-eight participants were enrolled, and 142 completed the study for data analysis. Participants were divided into patients with MDD (n=58) and without MDD, i.e., controls (n=84). The Oral Glucose Tolerance Test (OGTT) was conducted, and the serum cortisol levels of each participant were also measured. Demographic variables were analyzed using t-tests or chi-square tests. Covariance analysis was conducted to test the measures derived from OGTT and cortisol levels between groups. Results: There was no difference in fasting glucose, 2-hour post-prandial levels, and indices of insulin sensitivity between MDD and control groups. However, in a stratified and sex-comparative analysis, female participants with MDD had higher fasting glucose and cortisol levels than female controls, but this was not seen in males. Also, fasting glucose was positively correlated with the severity of depression in females with MDD. Conclusion: Females with MDD have the highest risk of developing prediabetes compared to female controls and males, possibly through cortisol. Fasting glucose and cortisol could be biomarkers to recognize prediabetes in females with MDD for early intervention and better outcomes.