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World J Psychiatry. Oct 19, 2026; 16(10): 121314
Published online Oct 19, 2026. doi: 10.5498/wjp.121314
Published online Oct 19, 2026. doi: 10.5498/wjp.121314
Glycemic indicators influence hypercoagulability via multisystem pathways in psychiatric inpatients: Structural equation modeling
Jie Wei, Hong-Ying Du, Office of Nutrition and Dietetics, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Qian He, Shao-Shen Jia, Fu-Gang Luo, Yi-Chao Wang, Psychiatric Emergency Department and Psychiatric Intensive Care Units, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Author contributions: Wei J, Du HY and He Q conceptualized and designed the research study; Jia SS, Luo FG and Wei J contributed to data acquisition, extraction, and preprocessing; Wang YC and Wei J performed the structural equation modeling and statistical analysis; He Q and Jia SS interpreted the results and drafted the manuscript; Du HY and Luo FG critically revised the manuscript for important intellectual content; and all authors reviewed and approved the final version of the manuscript.
AI contribution statement: The authors declare that no artificial intelligence (AI) tools or AI-assisted technologies were used in any stage of the preparation, writing, data analysis, or editing of this manuscript. The authors assume full responsibility and accountability for the integrity, accuracy, originality, and scientific validity of all submitted materials.
Supported by the Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, No. 2025063001; and the Construction Fund of Key Medical Disciplines of Hangzhou, No. 2025HZGF10.
Institutional review board statement: The studies involving humans were approved by the Ethics Committee of Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine (No. 070). The studies were conducted in accordance with the local legislation and institutional requirements. The ethics committee/institutional review board waived the requirement of written informed consent for participation from the participants or the participants’ legal guardians/next of kin because of the retrospective nature of the study; all procedures were considered routine medical practices.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The authors intend to share all individual deidentified participant data except for patients’ privacy. Under the request, the authors will send related data by email. These data will be available from publication to 5 years after publication.
Corresponding author: Yi-Chao Wang, MD, Psychiatric Emergency Department and Psychiatric Intensive Care Units, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, No. 305 Tianmu South Road, Hangzhou 310000, Zhejiang Province, China. wangyichao@hz7hospital.com
Received: March 23, 2026
Revised: May 29, 2026
Accepted: July 1, 2026
Published online: October 19, 2026
Processing time: 203 Days and 6.9 Hours
Revised: May 29, 2026
Accepted: July 1, 2026
Published online: October 19, 2026
Processing time: 203 Days and 6.9 Hours
Core Tip
Core Tip: This study innovatively applies structural equation modeling to reveal how glycemic indicators across different time scales influence hypercoagulability, marked by D-dimer, in psychiatric inpatients. Fasting plasma glucose actively promotes hypercoagulability via inflammatory pathways. Conversely, fructosamine robustly protects against it, acting as a surrogate for nutritional and anticoagulant reserves rather than mere glycemic control. Glycated hemoglobin showed negligible direct acute effects. These findings shift the paradigm of psychiatric coagulopathy from a simplistic metabolic complication to a multi-system cascade, highlighting the necessity of integrated metabolic, inflammatory, and nutritional clinical assessments.