失眠对中国大学生尿邻苯二甲酸酯代谢物与抑郁症状关联的调节作用：关注性别差异

Moderating effects of insomnia on the association between urinary phthalate metabolites and depressive symptoms in Chinese college students: focus on gender differences

失眠对中国大学生尿邻苯二甲酸酯代谢物与抑郁症状关联的调节作用：关注性别差异

Authors：Tingting Li, Shuman Tao, Tangjun Jiang, Wanyu Che, Liwei Zou, Yajuan Yang, Fangbiao Tao, Xiaoyan Wu

Source：BMC Public Health

PMID: 40016718

DOI: 10.1186/s12889-025-21986-z

Abstract

Objectives: To investigate the rates of depressive symptoms in college students, explore the relationship between urinary phthalate metabolites and depressive symptoms and their gender differences, and further explore the moderating role of insomnia in this association.

Methods: A total of 1 179 college students were recruited from 2 universities in Hefei and Shangrao cities from April to May 2019. The depressive symptoms and insomnia of college students were investigated by the Patient Health Questionnaire 9 and Insomnia Severity Index. The high-performance liquid chromatography-tandem mass spectrometry was adapted to determine the concentration of urinary phthalate metabolites. The generalized linear model was used to analyze the relationship of phthalate metabolites with depressive symptoms. Moderating analysis was used to examine whether insomnia moderated the relationship of phthalate metabolites with depressive symptoms.

Results: The rates of mild depression, and moderate depression and above in college students were 31.9% and 9.2%, respectively. The phthalate metabolites exhibited a median and mean concentration spanning from 2.98~156.55 ng/mL and 6.12~ 205.53 ng/mL. The generalized linear model results showed that monobutyl phthalate (MBP) (β = 1.160, 95%CI: 0.423 ~ 1.896) and low molecular weight phthalate (LMWP) (β = 1.230, 95%CI: 0.348 ~ 2.113) were positively correlated with depressive symptoms, and MBP (β = 1.320, 95%CI: 0.453~ 2.187) and LMWP (β = 1.396, 95%CI: 0.351 ~ 2.440) were positively correlated with depressive symptoms only in female college students after stratified by gender. Furthermore, insomnia has a positive moderating role between MBP, LMWP, and depressive symptoms and has a sex-based difference.

Conclusions: This study suggests that there is a positive association of phthalate metabolites with depressive symptoms among Chinese college students, as well as insomnia plays a positive moderating role in this association.

Keywords: College students; Depressive symptoms; Insomnia; Phthalate metabolites.

摘要

目的：调查大学生抑郁症状发生率，探讨尿邻苯二甲酸酯代谢物与抑郁症状的关联及其性别差异，并进一步探讨失眠在这种关联中的调节作用。

方法：2019年4—5月，从合肥市和上饶市的2所高校共招募了1 179名大学生。采用《患者健康问卷-9项》（Patient Health Questionnaire 9，PHQ 9）及《失眠严重程度指数》（Insomnia Severity Index，ISI）调查大学生的抑郁症状和失眠情况。采用高效液相色谱-串联质谱法测定尿邻苯二甲酸酯代谢物的浓度。采用广义线性模型分析邻苯二甲酸酯代谢物与抑郁症状的关联。采用调节分析检查失眠是否在邻苯二甲酸酯代谢物与抑郁症状的关联中起调节作用。

结果：大学生轻度抑郁、中度及以上抑郁的发生率分别为31.9%和9.2%。邻苯二甲酸酯代谢物的中位浓度和平均浓度范围分别为2.98~156.55 ng/mL和6.12~205.53 ng/mL。广义线性模型结果显示，MBP（β＝1.160，95%CI：0.423~1.896）和LMWP（β＝1.230，95%CI：0.348~2.113）与抑郁症状呈正相关。按性别分层后，MBP（β＝1.320，95%CI：0.453~2.187）和LMWP（β＝1.396，95%CI：0.351~2.440）仅在女大学生中与抑郁症状呈正相关。此外，失眠在MBP、LMWP与抑郁症状的关联中具有正向调节作用，且存在性别差异。

结论：本研究表明，邻苯二甲酸酯代谢物与中国大学生抑郁症状呈正相关，且失眠在这一关联中起正向调节作用。

关键词：大学生；抑郁症状；失眠；邻苯二甲酸酯代谢物。