Bartoli Francesco, Carrà Giuseppe, Crocamo Cristina, Carretta Daniele, La Tegola Davide, Tabacchi Tommaso, Gamba Pierluigi, Clerici Massimo
Department of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy.
Division of Psychiatry (Formerly Mental Health Sciences), University College London, London, UK.
Int J Geriatr Psychiatry. 2016 Aug;31(8):829-36. doi: 10.1002/gps.4397. Epub 2016 Jan 4.
Depression and neuropathy are frequent complications of type 2 diabetes. The current meta-analysis aimed to estimate the association between depression and neuropathy in subjects with type 2 diabetes.
We systematically searched electronic databases for articles published up to February 2015, providing data on the association between depression and neuropathy in individuals with type 2 diabetes. No language restrictions were applied. The meta-analysis generated random-effect odds ratios with 95% confidence intervals (95% CI). Risk of publication bias and heterogeneity were estimated using the Egger test and I(2) index, respectively. Leave-one-out analysis was performed. Data were analysed using stata.
Thirteen studies were included in the meta-analysis. Data on the association between depression and neuropathy were available for 3898 individuals with type 2 diabetes. Pooled analysis showed an association between depression and neuropathy, with an odds ratio of 2.01 (95% CI: 1.60-2.54; p < 0.001). There was no risk of publication bias (p = 0.064), and heterogeneity was moderate (I(2) = 44.5%). Leave-one-out analysis confirmed consistency of the findings. The association appeared partly influenced by age, because studies selecting older people (sample mean age > 65 years) showed a slightly higher estimate for the association.
We found an association between depression and neuropathy among people with type 2 diabetes. Because of the cross-sectional nature of included studies, the relationship between these two conditions might be bidirectional. Further research exploring factors that might moderate or mediate this association is needed. Targeted interventions for comorbid depression and neuropathy should be implemented in clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.
抑郁症和神经病变是2型糖尿病常见的并发症。当前的荟萃分析旨在评估2型糖尿病患者中抑郁症与神经病变之间的关联。
我们系统检索了截至2015年2月发表的电子数据库，以获取有关2型糖尿病患者抑郁症与神经病变之间关联的数据。未设语言限制。荟萃分析生成了具有95%置信区间（95%CI）的随机效应比值比。分别使用Egger检验和I²指数评估发表偏倚风险和异质性。进行了留一法分析。使用Stata软件对数据进行分析。
13项研究纳入了荟萃分析。共有3898名2型糖尿病患者提供了抑郁症与神经病变之间关联的数据。汇总分析显示抑郁症与神经病变之间存在关联，比值比为2.01（95%CI：1.60 - 2.54；p < 0.001）。不存在发表偏倚风险（p = 0.064），异质性为中度（I² = 44.5%）。留一法分析证实了研究结果的一致性。该关联似乎部分受年龄影响，因为选择老年人（样本平均年龄>65岁）的研究显示关联估计值略高。
我们发现2型糖尿病患者中抑郁症与神经病变之间存在关联。由于纳入研究的横断面性质，这两种情况之间的关系可能是双向的。需要进一步研究探索可能调节或介导这种关联的因素。临床实践中应针对抑郁症和神经病变共病实施有针对性的干预措施。版权所有© 2016约翰威立父子有限公司。
