Department of Clinical Pharmacology, College of Health Sciences, University of Zimbabwe, PO Box A 178, Avondale, Harare, Zimbabwe.
Int J Clin Pharm. 2012 Jun;34(3):432-8. doi: 10.1007/s11096-012-9608-4. Epub 2012 Jan 18.
Recent evidence from case reports, observational studies, and randomized trials suggests that long-term use of antidepressants increases the risk of developing diabetes. However, the nature of the relationship between antidepressants and diabetes remains unclear.
To determine whether there is an association between antidepressant use and the risk of developing type 2 diabetes mellitus.
A nested case-control study using the Texas Medicaid prescription claims database was conducted. Data were extracted for new users of either antidepressant agents (exposed) or benzodiazepines (unexposed) from January 1, 2002 through December 31, 2009. Patients aged 18-64 years without a history of diabetes were included in the cohort. The adjusted odds ratio (OR) and 95% confidence interval (CI) for the risk of diabetes associated with antidepressant exposure was computed using conditional logistic regression, controlling for demographic and clinical covariates.
Development of type 2 diabetes mellitus.
Among the total sample (N = 44,715), the majority were in the exposed (N = 35,552) vs. the unexposed (N = 9,163) group. A total of 2,943 cases of type 2 diabetes mellitus and 11,748 matched controls (1:4) were identified using risk-set sampling. Cases and controls were matched using age and gender. Antidepressant use was associated with an increase in the risk of (type-2) diabetes when compared to benzodiazepine use [Adjusted Odds Ratio (OR) = 1.512; 95% CI 1.345-1.700]. The association was observed with serotonin-norepinephrine reuptake inhibitors (OR = 1.742; 95% CI 1.472-2.060), tricyclic antidepressants (OR = 1.533; 95% CI 1.295-1.814), selective serotonin reuptake inhibitors (OR = 1.457; 95% CI 1.279-1.659), "Other" antidepressants (OR = 1.318; 95% CI 1.129-1.540).
Antidepressant use was associated with an increased risk of (type-2) diabetes. This association was observed for tricyclic antidepressants, serotonin-reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and other antidepressants.
最近的病例报告、观察性研究和随机试验的证据表明，长期使用抗抑郁药会增加患糖尿病的风险。然而，抗抑郁药与糖尿病之间的关系性质仍不清楚。
确定使用抗抑郁药与 2 型糖尿病发病风险之间是否存在关联。
使用德克萨斯州医疗补助处方索赔数据库进行了一项嵌套病例对照研究。从 2002 年 1 月 1 日至 2009 年 12 月 31 日，纳入新使用抗抑郁药（暴露组）或苯二氮䓬类药物（未暴露组）的患者。年龄在 18-64 岁之间且无糖尿病史的患者被纳入队列。使用条件逻辑回归计算与抗抑郁药暴露相关的糖尿病风险的调整比值比（OR）和 95%置信区间（CI），控制人口统计学和临床协变量。
2 型糖尿病的发生。
在总样本（N=44715）中，大多数患者处于暴露组（N=35552）与未暴露组（N=9163）。使用风险集抽样确定了 2943 例 2 型糖尿病病例和 11748 例匹配对照（1:4）。病例和对照按年龄和性别匹配。与使用苯二氮䓬类药物相比，使用抗抑郁药与 2 型糖尿病风险增加相关[调整后的比值比（OR）=1.512；95%置信区间（CI）为 1.345-1.700]。这种关联在使用 5-羟色胺去甲肾上腺素再摄取抑制剂（OR=1.742；95%CI 1.472-2.060）、三环类抗抑郁药（OR=1.533；95%CI 1.295-1.814）、选择性 5-羟色胺再摄取抑制剂（OR=1.457；95%CI 1.279-1.659）和“其他”抗抑郁药（OR=1.318；95%CI 1.129-1.540）时观察到。
使用抗抑郁药与（2 型）糖尿病风险增加相关。这种关联在三环类抗抑郁药、5-羟色胺再摄取抑制剂、5-羟色胺去甲肾上腺素再摄取抑制剂和其他抗抑郁药中均观察到。
