糖尿病患者体重管理的 LOOK AHEAD（糖尿病患者健康行动）临床试验中的心血管疾病危险因素、抑郁症状和抗抑郁药物使用。
Cardiovascular disease risk factors, depression symptoms and antidepressant medicine use in the Look AHEAD (Action for Health in Diabetes) clinical trial of weight loss in diabetes.
机构信息
Department of Medicine, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA.
出版信息
Diabetologia. 2010 Aug;53(8):1581-9. doi: 10.1007/s00125-010-1765-1. Epub 2010 Apr 28.
AIMS/HYPOTHESIS: To determine the associations of baseline depression symptoms and use of antidepressant medicines (ADMs) with baseline cardiovascular disease (CVD) risk factors in Look AHEAD (Action for Health in Diabetes) trial participants.
METHODS
Look AHEAD participants (n = 5,145; age 58.7 +/- 6.8 years; BMI 35.8 +/- 5.8 kg/m(2)) were assessed for CVD risk factors (elevated HbA(1c) or insulin use, elevated BP or antihypertensive use, elevated lipid levels or lipid-lowering medication, current smoking, BMI > or = 30 kg/m(2), lower peak exercise capacity assessed as metabolic equivalents [METs], and ankle-brachial index <0.9 or >1.3). Participants also completed the Beck Depression Inventory (BDI) and reported their use of ADMs.
RESULTS
Of the participants, 14.7% had BDI scores > or = 11, consistent with mild-moderate depression, and 16.5% took ADMs; 4.4% had both depression markers (i.e. elevated symptom scores and took ADMs). In logistic regression analyses of CVD risk (elevated risk factor or use of medication to control the risk factor), controlled for demographic factors, continuous BDI scores and ADM use were each independently associated with elevated BP (or medication), current smoking, BMI > or = 30 kg/m(2) and lower MET values. ADM use was also associated with elevated serum lipids or use of lipid-lowering medication.
CONCLUSIONS/INTERPRETATION: Among Look AHEAD participants, depression symptoms or ADM use on entry to the study were each independently associated with a wide range of CVD risk factors. Future research should assess the temporal dynamics of the relationships of depression symptoms and ADM use with CVD risk factors.
TRIAL REGISTRATION
Clinicaltrials.gov NCT00017953
FUNDING
This study is funded by the National Institutes of Health with additional support from the Centers for Disease Control and Prevention.
目的/假设：确定基线抑郁症状和使用抗抑郁药物（ADM）与 LOOK AHEAD（糖尿病中的健康行动）试验参与者的基线心血管疾病（CVD）危险因素之间的关联。
方法
对 LOOK AHEAD 参与者（n = 5145；年龄 58.7 +/- 6.8 岁；BMI 35.8 +/- 5.8 kg/m(2)）进行 CVD 危险因素评估（糖化血红蛋白升高或使用胰岛素、血压升高或使用抗高血压药物、血脂升高或使用降脂药物、当前吸烟、BMI >= 30 kg/m(2)、代谢当量 [MET] 评估的峰值运动能力降低，以及踝臂指数 <0.9 或 >1.3）。参与者还完成了贝克抑郁量表（BDI）并报告了他们使用 ADM 的情况。
结果
在参与者中，14.7%的 BDI 得分> = 11，符合轻度至中度抑郁，16.5%服用 ADM；4.4%有两种抑郁标志物（即升高的症状评分和服用 ADM）。在 CVD 风险（升高的风险因素或使用药物控制风险因素）的逻辑回归分析中，控制了人口统计学因素后，连续 BDI 评分和 ADM 使用均与血压升高（或药物）、当前吸烟、BMI >= 30 kg/m(2) 和较低的 MET 值独立相关。ADM 使用还与血清脂质升高或使用降脂药物有关。
结论/解释：在 LOOK AHEAD 参与者中，进入研究时的抑郁症状或 ADM 使用与 CVD 危险因素的广泛范围独立相关。未来的研究应该评估抑郁症状和 ADM 使用与 CVD 危险因素之间关系的时间动态。
临床试验注册
Clinicaltrials.gov NCT00017953
资金来源
本研究由美国国立卫生研究院资助，疾病控制与预防中心提供额外支持。
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