Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
Diabetologia. 2012 Jan;55(1):63-72. doi: 10.1007/s00125-011-2268-4. Epub 2011 Aug 3.
AIMS/HYPOTHESIS: The results of several studies have suggested a potential positive association between use of antidepressant medication (ADM) and incident type 2 diabetes mellitus. We examined this association in three cohorts of US adults.
We followed 29,776 men in the Health Professionals Follow-up Study (HPFS, 1990-2006), 61,791 women in the Nurses' Health Study I (NHS I, 1996-2008) and 76,868 women in NHS II (1993-2005), who were free of diabetes mellitus, cardiovascular disease or cancer at baseline. The mean baseline ages for participants from the HPFS and NHS I and II were 56.4, 61.3 and 38.1 years, respectively. ADM use and other covariates were assessed at baseline and updated every 2 years. A time-dependent Cox proportional hazards model was used, and HRs were pooled together across the three cohorts.
During 1,644,679 person-years of follow-up, we documented 6,641 new cases of type 2 diabetes. ADM use was associated with an increased risk of diabetes in all three cohorts in age-adjusted models (pooled HR 1.68 [95% CI 1.27, 2.23]). The association was attenuated after adjustment for diabetes risk factors and histories of high cholesterol and hypertension (1.30 [1.14, 1.49]), and further attenuated by controlling for updated BMI (1.17 [1.09, 1.25]). Use of selective serotonin reuptake inhibitors and other antidepressants (mainly tricyclic antidepressants) were both associated with an elevated risk of diabetes, with pooled multivariate-adjusted HRs of 1.10 (1.00, 1.22) and 1.26 (1.11, 1.42), respectively.
CONCLUSIONS/INTERPRETATION: The results suggest that ADM users had a moderately elevated risk of type 2 diabetes mellitus compared with non-users, even after adjustment for BMI.
目的/假设：几项研究的结果表明，使用抗抑郁药物（ADM）与 2 型糖尿病的发生之间存在潜在的正相关关系。我们在三个美国成年人队列中研究了这种关联。
我们随访了 29776 名男性（HPFS，1990-2006 年）、61791 名女性（NHS I，1996-2008 年）和 76868 名女性（NHS II，1993-2005 年），这些人在基线时没有糖尿病、心血管疾病或癌症。HPFS 和 NHS I 和 II 参与者的平均基线年龄分别为 56.4、61.3 和 38.1 岁。ADM 使用情况和其他协变量在基线时进行评估，并每两年更新一次。采用时间依赖性 Cox 比例风险模型，将 HR 汇总来自三个队列的数据。
在 1644679 人年的随访期间，我们记录了 6641 例新诊断的 2 型糖尿病病例。在所有三个队列中，ADM 使用与糖尿病风险增加相关，在年龄调整模型中，汇总 HR 为 1.68（95%CI 1.27，2.23）。在调整糖尿病风险因素、高胆固醇和高血压病史后，该关联减弱（1.30 [1.14，1.49]），进一步通过控制更新的 BMI 减弱（1.17 [1.09，1.25]）。选择性 5-羟色胺再摄取抑制剂和其他抗抑郁药（主要是三环抗抑郁药）的使用均与糖尿病风险升高相关，多变量调整后的汇总 HR 分别为 1.10（1.00，1.22）和 1.26（1.11，1.42）。
结论/解释：结果表明，与非使用者相比，ADM 使用者的 2 型糖尿病风险略高，即使在调整 BMI 后也是如此。
