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Updated: Sep 10, 2025

Differentiated Mouse Adipocytes in Primary Culture: A Model of Insulin Resistance
Published on: February 17, 2023
Insulin resistance mediates the association between sedentary behavior and depression: Evidence from a large-scale
Xun Huang1, Xiaoyang Yao2, Min Fang2
1Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 1, Minde Road, Donghu District, Nanchang 330006, Jiangxi Province, China; Department of Cardiovascular Medicine, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, No. 90, Bayi Avenue, Xihu District, Nanchang 330003, Jiangxi Province, China.
Background:
Although the relationship between sedentary behavior (SB) and depression has been demonstrated to be associated with insulin resistance, the mediating role of insulin resistance in the SB with depression relationship has not yet been systematically explored.
Methods:
We analyzed data from 11,270 adults in the National Health and Nutrition Examination Survey (NHANES) 2009-2018 to explore the mediating role of insulin resistance in the relationship between SB and depression. Four established insulin resistance indices were examined: the Metabolic Score for Insulin Resistance (METS-IR), Triglyceride-Glucose Index (TyG index), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and Atherogenic Index of Plasma (AIP).
Results:
Among 11,270 participants, 976 (8.7 %) had depression. Participants with depression more likely to be female (34.45 % vs. 64.55 %, P < 0.001), and exhibited higher insulin resistance markers. All four insulin resistance indices demonstrated significant mediation effects, with METS-IR showing the largest mediation proportion (15.29 %, indirect effect = 0.0034, 95 % CI: 0.0021, 0.0049), followed by AIP (6.34 %), TyG index (5.40 %), and HOMA-IR (4.76 %). Significant sex differences emerged (P for interaction = 0.014), with males showing stronger associations (OR = 1.08, 95 % CI: 1.04, 1.12) between SB and depression than females (OR = 1.02, 95 % CI: 0.99, 1.05). Threshold analysis revealed a critical 9-h daily sedentary time point exclusively in males, above which the odds of depression were significantly higher (OR = 1.15, 95 % CI: 1.06, 1.25, P < 0.001).
Conclusions:
Our findings suggest that insulin resistance may be a key biological mediator in the observed association between sedentary behavior and depression. Notably, we identified a 9-h sedentary threshold in males.
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