Impact of insulin resistance on post‐stroke depression and outcomes in diabetes

Q: What are the key findings of this study?

Insulin resistance was associated with a increased risk of 3-month post-stroke depression in diabetic stroke patients after IPTW adjustment.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute cerebral infarction and comorbid type 2 diabetes mellitus (n=124). Intervention: Insulin resistance (HOMA-IR > 2.69) vs. Control group without insulin resistance (HOMA-IR <= 2.69). Primary outcome: Post-stroke depression (PSD) incidence at 3 months (evaluated by HAMD-17) (OR 2.64, 95% CI 1.07-6.54, p=0.035).

Q: What does this research mean for the field?

Insulin resistance is independently associated with a significantly increased risk of post-stroke depression at 3 months in diabetic patients with acute cerebral infarction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Ming Tan; Jing Gong; Jinbiao Zhang

doi:10.1111/jdi.70097

June 18, 2025Journal of Diabetes InvestigationOpen Access

Impact of insulin resistance on post‐stroke depression and outcomes in diabetes

View Full Paper

Ask AI

Bookmark

Share

Key result

Insulin resistance linked to ~2.6-fold higher risk of post-stroke depression in diabetic patients.

OR 2.64
95% CI 1.07-6.54
P=0.035
n=124

Figures

Graphical abstract published by Journal of Diabetes Investigation — Graphical abstract · Published by Journal of Diabetes Investigation · CC BY-NC

Why the study?

This study examined the association between insulin resistance and post-stroke depression occurrence in diabetic patients to inform prevention and treatment strategies.

Does insulin resistance (HOMA-IR > 2.69) increase the risk of post-stroke depression at 3 months in patients with acute cerebral infarction and comorbid type 2 diabetes mellitus?

Key Points

To examine the association between insulin resistance and the occurrence of post-stroke depression in patients with diabetes mellitus following acute cerebral infarction.
Retrospectively analyzed clinical data from 124 patients with acute cerebral infarction and diabetes mellitus, followed up at 3 months post-stroke.
Stratified participants by Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) into an insulin-resistant group (HOMA-IR > 2.69, n = 96) and a control group (HOMA-IR ≤ 2.69, n = 28).
Evaluated depression severity using the 17-item Hamilton Depression Rating Scale (HAMD-17) and addressed confounding with inverse probability of treatment weighting (IPTW) and multivariable logistic regression.
At 3 months, the insulin resistance group showed significantly higher median HAMD scores (8 vs 6, P = 0.029) and an increased unadjusted post-stroke depression risk (OR = 3.28, 95% CI: 1.37–7.88, P = 0.006).
After adjusting for baseline confounders using IPTW, the insulin resistance group maintained a significantly elevated risk of depression (adjusted OR = 2.64, 95% CI: 1.07–6.54, P = 0.035).
Multivariable logistic regression confirmed HOMA-IR independently predicted post-stroke depression (OR = 1.755, 95% CI: 1.360–2.263, P < 0.001), with ROC analysis showing an AUC of 0.76 (cutoff 5.2, sensitivity 51.4%, specificity 94.2%).

Study Design

Type

Cohort (n=124)

Multicenter

No

Structured PICO

Does insulin resistance (HOMA-IR > 2.69) increase the risk of post-stroke depression at 3 months in patients with acute cerebral infarction and comorbid type 2 diabetes mellitus?

P

Population

124 Chinese adults (age range 31-86 years, 45.2% female) with first-onset acute cerebral infarction (<2 weeks duration) and comorbid type 2 diabetes mellitus, free of prior psychiatric history, followed for 3 months.

E

Exposure

Insulin resistance group (defined as Homeostasis Model Assessment of Insulin Resistance [HOMA-IR] > 2.69, n = 96)

C

Comparator

Control group without insulin resistance (defined as HOMA-IR ≤ 2.69, n = 28)

O

Outcome

Incidence and severity of post-stroke depression (PSD), assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17, where a score of 7-17 suggests probable depression), at 3-month follow-up.patient reported

Main Result

Odds Ratio: 2.64 (95% CI 1.07–6.54)

Absolute Event Rate: 64.58% vs 35.71%

p-value: p=0.035

Elevated insulin resistance (HOMA-IR) is an independent predictor of 3-month post-stroke depression in diabetic patients with acute cerebral infarction, demonstrating high specificity (94.2% at cutoff 5.2) as a potential clinical rule-out tool.

Limitations

Single-center retrospective design with a moderate sample size (n = 124) and small control group (n = 28)
The 3-month observation period was insufficient to assess long-term outcomes
Potential residual confounding from unmeasured variables such as the use of insulin sensitizers or antidepressants
Single-center design with a moderate sample size (n = 124), particularly a small control group (n = 28)
Potential residual confounding from unmeasured variables such as the use of insulin sensitizers

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Does not yet support HOMA-IR screening to guide post-stroke depression care in diabetes; leaves open whether targeting insulin resistance improves outcomes.

Abstract

AIMS: This study aimed to examine the association between insulin resistance (IR) and post-stroke depression (PSD) occurrence in diabetic patients, providing novel insights for PSD prevention and treatment strategies. MATERIALS AND METHODS: Clinical data from 124 patients with acute cerebral infarction and diabetes mellitus were retrospectively analyzed. Based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), participants were stratified into two groups: an IR group (HOMA-IR > 2.69, n = 96) and a control group (HOMA-IR ≤ 2.69, n = 28). The occurrence of PSD was compared between the two groups by unadjusted analysis and inverse probability of treatment weighting (IPTW), and the correlation between HOMA-IR scores and PSD was analyzed by multivariate logistic regression. RESULTS: At 3-month follow-up, the IR group exhibited significantly higher Hamilton Depression Scale (HAMD) scores (median 8 vs 6, P = 0.029) and a 3.28-fold increased PSD risk (OR = 3.28, 95% CI: 1.37-7.88, P = 0.006). After adjusting for baseline confounders using IPTW, the IR group maintained elevated PSD risk (adjusted OR = 2.64, P = 0.035). Multivariate analysis confirmed HOMA-IR as an independent PSD predictor (OR = 1.755, 95% CI: 1.360-2.263, P < 0.001), with ROC analysis demonstrating moderate predictive accuracy (AUC = 0.76, 51.4% sensitivity, 94.2% specificity at cutoff 5.2). CONCLUSIONS: Elevated HOMA-IR levels in diabetic patients with acute cerebral infarction are significantly associated with increased PSD incidence.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Tan et al. (2025) conducted a cohort in Acute cerebral infarction and comorbid type 2 diabetes mellitus (n=124). Insulin resistance (HOMA-IR > 2.69) vs. Control group without insulin resistance (HOMA-IR <= 2.69) was evaluated on Post-stroke depression (PSD) incidence at 3 months (evaluated by HAMD-17) (OR 2.64, 95% CI 1.07-6.54, p=0.035). Insulin resistance was associated with a increased risk of 3-month post-stroke depression in diabetic stroke patients after IPTW adjustment.

synapsesocial.com/papers/6a80b1bb03a7c7d587cb0556 https://doi.org/10.1111/jdi.70097

View Full Paper

Ask AI

Bookmark

Share

Impact of insulin resistance on post‐stroke depression and outcomes in diabetes

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Impact of insulin resistance on post‐stroke depression and outcomes in diabetes

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading