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美国非西班牙裔黑人、白人及墨西哥裔美国2型糖尿病成年人抗抑郁治疗使用情况的比较

A Comparison of the Use of Antidepressant Treatment Between Non-Hispanic Black and White and Mexican American Adults With Type 2 Diabetes in the United States.

作者信息

Perez Alexandra, Cabrera Pierina, Gutierrez Carolina, Valdes Jose

机构信息

Sociobehavioral and Administrative Pharmacy Department, Nova Southeastern University College of Pharmacy, Davie, FL (Dr Perez).

Nova Southeastern University College of Pharmacy, Davie, FL (Dr Cabrera, Dr Gutierrez).

出版信息

Diabetes Educ. 2017 Apr;43(2):171-179. doi: 10.1177/0145721717697191.

Abstract

Purpose The purpose of this study was to determine antidepressant use among Mexican Americans (MA) and non-Hispanic (NH) blacks and whites with type 2 diabetes and depressive symptoms. Methods A secondary data analysis based on National Health and Nutrition Examination Survey (NHANES) 2005-2012 cohort data included 560 noninstitutionalized civilian MA, NH black, and NH white adults with type 2 diabetes and depressive symptoms. Unadjusted and adjusted 2-way ANOVA models evaluated whether there was a difference in the use of antidepressants by depressive symptom level across race/ethnic group. Results Whites were more likely than blacks and MA to be on antidepressant treatment (whites: 41.7%, blacks: 27.1%, MA: 24.2%) and on serotonin-norepinephrine reuptake inhibitors (SNRI) (whites: 8.1%, blacks: 2.9%, MA: 2.4%). However, there was no difference in the use of other drug classes or antidepressant use by depressive symptom level across racial/ethnic group. Followed by tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI) were the most commonly used drug class overall. Approximately 30% of subjects were on antidepressants and among those, 80% were on one antidepressant, all others on 2 or more. Conclusions Racial/ethnic differences were observed in the use of antidepressant treatment but not when depressive symptom levels were incorporated in the analyses. Further studies on the effectiveness of different antidepressants in diabetes outcomes minorities are needed.

摘要

目的 本研究旨在确定患有2型糖尿病且有抑郁症状的墨西哥裔美国人(MA)、非西班牙裔(NH)黑人和白人中抗抑郁药的使用情况。方法 基于2005 - 2012年国家健康与营养检查调查(NHANES)队列数据进行二次数据分析,纳入了560名患有2型糖尿病且有抑郁症状的非机构化平民MA、NH黑人及NH白人成年人。未调整和调整后的双向方差分析模型评估了不同种族/族裔群体中,抗抑郁药使用情况在抑郁症状水平上是否存在差异。结果 白人比黑人和MA更有可能接受抗抑郁药治疗(白人:41.7%,黑人:27.1%,MA:24.2%)以及使用5-羟色胺去甲肾上腺素再摄取抑制剂(SNRI)(白人:8.1%,黑人:2.9%,MA:2.4%)。然而,不同种族/族裔群体在其他药物类别使用情况或抑郁症状水平的抗抑郁药使用上并无差异。总体而言,继三环类抗抑郁药(TCA)之后,选择性5-羟色胺再摄取抑制剂(SSRI)是最常用的药物类别。约30%的受试者服用抗抑郁药,其中80%服用一种抗抑郁药,其余服用两种或更多种。结论 在抗抑郁药治疗的使用上观察到了种族/族裔差异,但在分析中纳入抑郁症状水平时则未观察到差异。需要进一步研究不同抗抑郁药对糖尿病结局少数群体的有效性。

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