Objective To evaluate the value of serum adiponectin combined with leptin in predicting the therapeutic efficacy for patients with generalized anxiety disorder (GAD).

Methods A total of 187 patients with GAD from January 2024 to January 2025 were selected as the GAD group, and 187 healthy individuals with physical examinations in the same period were selected as the control group. Enzyme-linked immunosorbent assay was used to detect the serum levels of adiponectin and leptin. According to the therapeutic efficacy, patients with GAD were divided into remission group Hamilton Anxiety Scale (HAMA) score≤7 points and non-remission group (HAMA score>7 points). Multivariate Logistic regression analysis was used to explore the influencing factors of therapeutic efficacy in patients with GAD. The receiver operating characteristic (ROC) curve analysis was used to analyze the predictive value of serum adiponectin combined with leptin for the therapeutic efficacy in patients with GAD.

Results Compared with the control group, the serum adiponectin level in the GAD group decreased significantly, while the leptin level increased significantly (P < 0.001). The non-remission rate in the 187 patients with GAD after treatment was 48.66% (91/187). Univariate analysis results showed that there were significant differences in HAMA score, the Generalized Anxiety Disorder-7 (GAD-7) score, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, leptin level, and adiponectin level between the remission group and the non-remission group (P < 0.05). Multivariate Logistic regression analysis showed that an increase in HAMA score (OR=1.245, 95%CI, 1.074 to 1.443, P=0.004), an increase in GAD-7 score (OR=1.254, 95%CI, 1.036 to 1.516, P=0.020), and an elevation in leptin level (OR=1.446, 95%CI, 1.235 to 1.693, P < 0.001) were independent risk factors for non-remission in patients with GAD, while an elevation in adiponectin level (OR=0.544, 95%CI, 0.430 to 0.688, P < 0.001) was an independent protective factor. The areas under the curve of the ROC curves for serum adiponectin level alone, leptin level alone, and their combined prediction of therapeutic efficacy in patients with GAD were 0.808, 0.792, and 0.898 respectively, with sensitivities of 0.725, 0.802, and 0.791 respectively, and specificities of 0.708, 0.635, and 0.833 respectively. The predictive value of their combination was significantly higher than that of serum adiponectin or leptin level alone (P < 0.05).

Conclusion A decreased serum adiponectin level and an increased leptin level are closely related to poor treatment response in patients with GAD, and their combination has a relatively high predictive value for the therapeutic efficacy in patients with GAD.