Knol Mirjam J, Geerlings Mirjam I, Egberts Antoine C G, Gorter Kees J, Grobbee Diederick E, Heerdink Eibert R
Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
Int Clin Psychopharmacol. 2007 Nov;22(6):382-6. doi: 10.1097/YIC.0b013e3282202c0e.
This study investigated whether the association between depression and diabetes was influenced by the presence of chronic somatic disease. To distinguish between depression and other psychosocial complaints, we studied the onset of diabetes in antidepressant (AD) users and benzodiazepine (BD) users, respectively. From the PHARMO database, which includes complete drug prescription data, we identified subjects using (i) no ADs and no BDs; (ii) AD but no BD; (iii) BD but no AD; and (iv) AD and BD. A total of 60 516 individuals (age: 45.5+/-17 years; 42.1% men) were followed from their first prescription for AD or BD until end of registration or a first prescription for antidiabetic drugs. The crude incidence rate in AD but no BD users was not increased compared with no AD and no BD users. After adjustment for age, sex and chronic diseases, the hazard ratios (95% confidence interval) were 1.05 (0.88-1.26) for AD but no BD users, 1.21 (1.02-1.43) for BD but no AD users and 1.37 (1.12-1.68) for AD and BD users compared with no AD and no BD users. We did not find an increased risk of diabetes in individuals using ADs. The association between BD use and diabetes was partly explained by chronic somatic comorbidity.
本研究调查了抑郁症与糖尿病之间的关联是否受到慢性躯体疾病的影响。为了区分抑郁症与其他社会心理问题,我们分别研究了抗抑郁药(AD)使用者和苯二氮䓬类药物(BD)使用者中糖尿病的发病情况。从包含完整药物处方数据的PHARMO数据库中,我们确定了使用以下药物的受试者:(i)未使用AD和BD;(ii)使用AD但未使用BD;(iii)使用BD但未使用AD;以及(iv)同时使用AD和BD。共有60516名个体(年龄:45.5±17岁;男性占42.1%)从首次开具AD或BD处方开始随访,直至登记结束或首次开具抗糖尿病药物处方。与未使用AD和BD的使用者相比,仅使用AD但未使用BD的使用者的粗发病率并未增加。在对年龄、性别和慢性病进行调整后,与未使用AD和BD的使用者相比,仅使用AD但未使用BD的使用者的风险比(95%置信区间)为1.05(0.88 - 1.26),仅使用BD但未使用AD的使用者为1.21(1.02 - 1.43),同时使用AD和BD的使用者为1.37(1.12 - 1.68)。我们未发现使用AD的个体患糖尿病的风险增加。使用BD与糖尿病之间的关联部分可由慢性躯体合并症来解释。