Interaction of serum resistin and smoking behavior in predicting depression risk: a sex-sensitive analysis

Affective disorders often co-occur with behavioral risk factors like smoking, and chronic metabolic disorders like obesity or type 2 diabetes. One possible regulation factor in these comorbidities could be resistin, an adipokine involved in inflammation and insulin resistance. Here, we investigate these factors in depressed patients, in a sex-sensitive approach.

We assessed depression symptoms in a sex-balanced cohort using the Beck Depression Inventory-II and the Male Depression Risk Scale. We further evaluated smoking behavior using self-report and the Fagerström Test for Nicotine Dependence. Resistin levels were measured in blood samples.

Higher resistin levels were associated with increased risk of major depressive disorder (MDD) in a sex- and smoking-dependent manner, with the strongest effect observed in female smokers and ex-smokers. No association was found between resistin and depression severity, while alcohol use emerged as the strongest predictor of masculine depression symptoms.

This study demonstrates that resistin interacts with smoking and sex to increase MDD risk, particularly in female smokers/ex-smokers, highlighting the importance of preventive strategies targeting depression risk in women with comorbid risk behaviors such as smoking.

German Clinical Trials Register ID DRKS00015291, registration date 2020-01-06, retrospectively registered.