Sleep difficulties may be one explanatory factor in the association between depression and insulin resistance; yet, explicit tests of this hypothesis are lacking. We determined if there was an indirect effect of depression symptoms on insulin resistance through sleep duration in adolescents at risk for excess weight gain. We also investigated whether dispositional mindfulness moderated the interconnections among depression, sleep, and insulin resistance. Ninety adolescents (14.2 ± 1.6y; 50% female) at risk for excess weight gain (body mass index [BMI, kg/m²] z score 1.6 ± 0.6) participated in the cross-sectional, baseline phase of a health behaviors study. Depression was assessed with the Center for Epidemiologic Studies–Depression Scale, sleep duration with the Sleep Habits Survey, and mindfulness with the Mindful Attention and Awareness Scale. Homeostatic model assessment of insulin resistance was determined from fasting insulin and glucose. The product-of-coefficients method was used to test the indirect effect of depression on insulin resistance through sleep duration, accounting for age, sex, BMIz, puberty, and socioeconomic status (SES). Dispositional mindfulness was tested as a moderator of the associations among depression, sleep, and insulin resistance. There was a significant indirect effect of depression on insulin resistance through sleep duration, controlling for age, sex, BMIz, puberty, and SES, 95%CI [0.001, 0.05]. Dispositional mindfulness moderated the association between sleep duration and insulin resistance, such that lower sleep duration related to greater insulin resistance only among adolescents with lower mindfulness (p < .001). Short sleep may be one explanatory factor in the depression-insulin resistance connection in adolescents at risk for excess weight gain. Adolescents with poorer mindfulness and short sleep are at highest risk for insulin resistance, whereas higher mindfulness may be protective.

睡眠困难可能是抑郁症和胰岛素抵抗之间关联的一个解释因素；然而，缺乏对这一假设的明确检验。我们确定抑郁症状是否通过睡眠持续时间对有超重风险的青少年的胰岛素抵抗产生间接影响。我们还调查了性格正念是否调节抑郁、睡眠和胰岛素抵抗之间的相互联系。90 名青少年（14.2 ± 1.6 岁；50% 为女性）有超重风险（体重指数 [BMI, kg/m ²] z 得分 1.6 ± 0.6) 参与了健康行为研究的横断面基线阶段。使用流行病学研究中心抑郁量表评估抑郁症，使用睡眠习惯调查评估睡眠持续时间，使用正念注意力和意识量表评估正念。胰岛素抵抗的稳态模型评估是根据空腹胰岛素和葡萄糖确定的。系数乘积法用于测试抑郁症通过睡眠持续时间对胰岛素抵抗的间接影响，考虑到年龄、性别、BMIz、青春期和社会经济地位 (SES)。性格正念作为抑郁、睡眠和胰岛素抵抗之间关联的调节剂进行了测试。抑郁症通过睡眠持续时间对胰岛素抵抗有显着的间接影响，控制年龄、性别、BMIz、青春期、和 SES，95%CI [0.001，0.05]。性格正念缓和了睡眠持续时间和胰岛素抵抗之间的关联，因此只有在正念较低的青少年中，较短的睡眠时间与较大的胰岛素抵抗有关（p  <.001）。睡眠不足可能是体重增加过多风险青少年的抑郁症-胰岛素抵抗联系的一个解释因素。正念较差和睡眠时间短的青少年发生胰岛素抵抗的风险最高，而正念较高可能具有保护作用。