Crispín-Trebejo Brenda, Robles-Cuadros María Cristina, Bernabé-Ortiz Antonio
Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú
Asia Pac Psychiatry. 2015 Dec;7(4):419-26. doi: 10.1111/appy.12190. Epub 2015 Jun 2.
There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined.
Cross-sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: <7% versus ≥7%), whereas the exposure of interest was depression defined as 15 or more points in the Patient Health Questionnaire-9 tool. The association of interest was evaluated using Poisson regression models with robust standard errors reporting prevalence ratios (PR) and 95% confidence intervals (95% CI) adjusting for potential confounders.
A total of 277 participants, 184 (66.4%) males, mean age 59.0 (SD: 4.8), and 7.1 (SD: 6.8) years of disease were analyzed. Only 31 participants (11.2%; 95% CI: 7.5%-14.9%) had moderately severe or severe depression, whereas 70 (25.3%; 95% CI 20.3%-30.8%) had good glycemic control. Depression increased the probability of having poor glycemic control (PR=1.32; 95% CI 1.15-1.51) after adjusting for several potential confounders.
There is an association between depression and poor glycemic control among type 2 diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications.
关于抑郁症对血糖控制的潜在影响,相关信息有限且存在争议。本研究旨在评估抑郁症与血糖控制不佳之间的关联。此外,还确定了抑郁症的患病率以及血糖控制不佳的发生率。
在秘鲁ESSALUD两家医院的内分泌科进行横断面研究。感兴趣的结局是血糖控制不佳,通过糖化血红蛋白进行评估(糖化血红蛋白<7%与≥7%),而感兴趣的暴露因素是抑郁症,通过患者健康问卷-9工具中15分及以上来定义。使用泊松回归模型评估感兴趣的关联,报告患病率比(PR)和95%置信区间(95%CI),并对潜在混杂因素进行调整。
共分析了277名参与者,其中184名(66.4%)为男性,平均年龄59.0岁(标准差:4.8),患病时间7.1年(标准差:6.8)。只有31名参与者(11.2%;95%CI:7.5%-14.9%)患有中度严重或重度抑郁症,而70名(25.3%;95%CI:20.3%-30.8%)血糖控制良好。在调整了几个潜在混杂因素后,抑郁症增加了血糖控制不佳的可能性(PR=1.32;95%CI:1.15-1.51)。
2型糖尿病患者中抑郁症与血糖控制不佳之间存在关联。我们的结果表明,早期发现抑郁症可能对促进适当的血糖控制和避免进一步的代谢并发症很重要。