葡萄糖调节受损和筛查发现的 2 型糖尿病患者中白种欧洲人和南亚人群中抑郁症状的流行情况：两种筛查工具的比较。

The prevalence of depressive symptoms in a white European and South Asian population with impaired glucose regulation and screen-detected Type 2 diabetes mellitus: a comparison of two screening tools.

机构信息

Department of Health Sciences, University of Leicester, Leicester, UK.

出版信息

Diabet Med. 2010 Aug;27(8):896-905. doi: 10.1111/j.1464-5491.2010.03042.x.

DOI:10.1111/j.1464-5491.2010.03042.x

PMID:20653747

Abstract

AIMS

To compare the identification of prevalent depressive symptoms by the World Health Organization-5 Wellbeing Index (WHO-5) and Centre for Epidemiological Studies Depression Scale (CES-D) for South Asian and white European people, male and female, attending a diabetes screening programme, and to explore the adequacy of the screening tools for this population. An additional aim was to further explore associations of depressive symptoms with impaired glucose regulation (IGR) and Type 2 diabetes mellitus (Type2 DM).

METHODS

Eight hundred and sixty-four white European (40-75 years old) and 290 South Asian people (25-75 years old) underwent an oral glucose tolerance test (OGTT), detailed history and anthropometric measurements and completed the WHO-5 and CES-D. Depressive symptoms were defined by a WHO-5 score <or= 13, and CES-D score >or= 16.

RESULTS

Unadjusted prevalence of depressive symptoms with the WHO-5, for people with Type2 DM was 42.3% (47.4% in white European; 28.6% in South Asian) and for IGR 30.7% (26% in white European; 45.8% in South Asian). With the CES-D, the prevalence in Type2 DM was 27.2% (25.4% in white European; 31.8% in South Asian) and for IGR 30.7% (27.8% in white European; 40.7% in South Asian). Statistically significant differences in the prevalence of depressive symptoms for sex or ethnicity were not identified. Odds ratios adjusted for age, sex and ethnicity showed no significant association of depression with Type2 DM or IGR, with either WHO-5 or CES-D. Agreement was moderate (kappa = 0.48, 95% confidence intervals 0.42-0.54), and reduced when identifying depressive symptoms in people with Type2 DM. For this group, a WHO-5 cut-point of <or= 10 was optimal.

CONCLUSIONS

Depressive symptoms, identified by WHO-5 or CES-D, were not significantly more prevalent in people with Type2 DM or IGR. The WHO-5 and CES-D differed in their identification of depressive symptoms in people with Type2 DM, though discrepancies between sex and ethnicity were not identified.

摘要

目的

比较世界卫生组织-5 项幸福感指数（WHO-5）和流行病学研究抑郁量表（CES-D）在南亚和白种欧洲人、男性和女性中识别普遍存在的抑郁症状的能力，这些人参加了糖尿病筛查计划，并探讨这些筛查工具在该人群中的充分性。另一个目的是进一步探讨抑郁症状与糖调节受损（IGR）和 2 型糖尿病（Type2 DM）的关系。

方法

864 名白种欧洲人（40-75 岁）和 290 名南亚人（25-75 岁）接受了口服葡萄糖耐量试验（OGTT）、详细病史和人体测量，并完成了 WHO-5 和 CES-D。抑郁症状的定义是 WHO-5 评分<或=13，CES-D 评分>或=16。

结果

未经调整的 WHO-5 评分显示，有 Type2 DM 的人抑郁症状的患病率为 42.3%（白种欧洲人为 47.4%；南亚人为 28.6%），IGR 为 30.7%（白种欧洲人为 26%；南亚人为 45.8%）。用 CES-D 评分，Type2 DM 的患病率为 27.2%（白种欧洲人为 25.4%；南亚人为 31.8%），IGR 为 30.7%（白种欧洲人为 27.8%；南亚人为 40.7%）。性别或种族之间抑郁症状的患病率没有统计学上的显著差异。调整年龄、性别和种族后，WHO-5 或 CES-D 与 Type2 DM 或 IGR 均无显著相关性。一致性中等（kappa=0.48，95%置信区间 0.42-0.54），在识别 Type2 DM 患者的抑郁症状时会降低。对于这一组，WHO-5 评分<或=10 是最佳的切点。