Rathmann W, Haastert B, Roseman J M, Giani G
Diabetes Research Institute (Dept. Biometrics and Epidemiology), Düsseldorf, Germany.
J Clin Epidemiol. 1999 Nov;52(11):1103-9. doi: 10.1016/s0895-4356(99)00082-7.
Our aim was to investigate the association of calcium channel blocker (CCB), beta-blocker, and ACE inhibitor medications with the risk of depression in diabetic patients. A case-control study was performed using an automated database (MediPlus, IMS) of 400 primary care practices in Germany including 972 diabetic cases with newly diagnosed depression in 1996 (index date) and 972 diabetic controls, matched for age, sex, and index date. The odds ratios (95%-confidence intervals) for depression, adjusted for type of practice, number of visits and prescriptions, hospitalization, cardiovascular diagnoses, and renal failure, were 2.2 (95% CI: 1.2-4.2) for exposure to CCB 6 months prior to index date, 2.6 (95% CI: 1.1-7.0) for beta-blockers, and 1.3 (95% CI: 0.8-2.2) for ACE inhibitors, respectively. Adjusted odds ratio for CCB (4.3; 95% CI: 1.7-13.5) and beta-blockers (4.5; 95% CI: 1.2-29.5) were higher with daily dosages above the median. Prescriptions of CCB and beta-blockers among diabetic patients may increase the risk of depression. Because this association may alternatively be explained by cardiovascular comorbidity, further studies will be necessary to investigate the link between these cardiovascular medications and depression.
我们的目的是研究钙通道阻滞剂（CCB）、β受体阻滞剂和血管紧张素转换酶（ACE）抑制剂药物与糖尿病患者抑郁症风险之间的关联。我们利用德国400家初级医疗诊所的自动化数据库（MediPlus，IMS）进行了一项病例对照研究，该数据库包含1996年（索引日期）新诊断为抑郁症的972例糖尿病病例以及972例年龄、性别和索引日期相匹配的糖尿病对照。在对诊所类型、就诊次数和处方数量、住院情况、心血管诊断以及肾衰竭进行校正后，索引日期前6个月接触CCB的抑郁症比值比（95%置信区间）为2.2（95%CI：1.2 - 4.2），β受体阻滞剂为2.6（95%CI：1.1 - 7.0），ACE抑制剂为1.3（95%CI：0.8 - 2.2）。当每日剂量高于中位数时，CCB（4.3；95%CI：1.7 - 13.5）和β受体阻滞剂（4.5；95%CI：1.2 - 29.5）的校正比值比更高。糖尿病患者中CCB和β受体阻滞剂的处方可能会增加抑郁症风险。由于这种关联也可能由心血管合并症来解释，因此有必要进一步研究这些心血管药物与抑郁症之间的联系。
