Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.
Douglas Mental Health University Institute, Montreal, Canada.
J Diabetes. 2019 Jan;11(1):14-22. doi: 10.1111/1753-0407.12822. Epub 2018 Aug 6.
Heavy alcohol consumption in individuals with type 2 diabetes mellitus (T2DM) is related to increased risks of diabetes-related micro- and macrovascular complications. Depressive symptoms may be relevant to this relationship, because high depressive symptoms are associated with an increased risk of complications. This study investigated whether the interaction between depressive symptoms and alcohol frequency was positively related to the development of neuropathy, retinopathy, nephropathy, and coronary artery disease (CAD), such that those with high depressive symptoms and high alcohol frequency will be at increased risk of complications.
Data were from five waves of the Evaluation of Diabetes Treatment annual survey including 1413 adults with T2DM in Quebec. Data on alcohol frequency (number of drinking occasions), depressive symptoms, and complications were collected annually. The development of each complication was investigated using multiple logistic regression analysis with generalized estimating equations.
After adjusting for sociodemographic, lifestyle, and diabetes-related covariates, the interaction between alcohol frequency and depressive symptoms was positively related to the incidence of neuropathy and CAD, such that those with high depressive symptoms who drank the most frequently had the highest risk of neuropathy (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.00-1.04; P = 0.04) and CAD (OR 1.02, 95% CI 1.00-1.04; P = 0.04). This interaction was not significantly related to retinopathy or nephropathy.
Individuals with high depressive symptoms and high alcohol frequency may have a particularly high risk of neuropathy and CAD. Future prevention efforts should examine both alcohol frequency and depressive symptoms when evaluating the risk of complications.
患有 2 型糖尿病（T2DM）的个体大量饮酒与糖尿病相关的微血管和大血管并发症风险增加有关。抑郁症状可能与这种关系有关，因为高抑郁症状与并发症风险增加有关。本研究旨在探讨抑郁症状和饮酒频率之间的相互作用是否与神经病变、视网膜病变、肾病和冠状动脉疾病（CAD）的发生呈正相关，即高抑郁症状和高饮酒频率的个体发生并发症的风险更高。
数据来自魁北克省的糖尿病治疗年度评估的五个随访期，共纳入了 1413 名患有 T2DM 的成年人。每年收集饮酒频率（饮酒次数）、抑郁症状和并发症的数据。使用广义估计方程的多变量逻辑回归分析来调查每种并发症的发生情况。
在调整了社会人口统计学、生活方式和糖尿病相关协变量后，饮酒频率和抑郁症状之间的相互作用与神经病变和 CAD 的发生呈正相关，即抑郁症状严重且饮酒最频繁的个体发生神经病变的风险最高（比值比 [OR] 1.02，95%置信区间 [CI] 1.00-1.04；P=0.04）和 CAD（OR 1.02，95% CI 1.00-1.04；P=0.04）。这种相互作用与视网膜病变或肾病无显著相关性。
抑郁症状严重且饮酒频繁的个体发生神经病变和 CAD 的风险可能特别高。未来的预防工作在评估并发症风险时应同时考虑饮酒频率和抑郁症状。
