APEC Health Science Academy, Peking University/Institute of Population Research, Peking University, Beijing 100871, China.
China Center for Health Development Studies, Peking University, Beijing 100191, China; Center for Health Policy and Management, Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China.
J Affect Disord. 2018 Nov;240:41-47. doi: 10.1016/j.jad.2018.07.026. Epub 2018 Jul 23.
Co-morbid diabetes and depression is common; however, little evidence was regarding the effect of education on this association. This study aimed to investigate the role of education in the effect of diabetes on depressive symptoms in China.
We used data from the China Health and Retirement Longitudinal Study, including 6,921 participants free from depressive symptoms in three waves of cohort study from 2011. We assessed the depressive symptoms based on Center for Epidemiological Studies-Depression scale. We fitted Cox proportional hazards regression models to examine the effect of baseline diabetes on the subsequent depressive symptoms.
Participants with diagnosed diabetes were more likely than their nondiabetic peers to develop depressive symptoms only in 45-64 years group, with a hazard ratio of 1.30 (95% CI: 1.05, 1.61). In addition, the effect of diagnosed diabetes on depressive symptoms only occurred in participants with a diploma of primary school or below.
Information was unavailable may offer additional explanatory power.
Our findings suggested that diagnosed diabetes was a chronic stressor in developing depressive symptoms, and that response to this stressor varied by individuals' educational attainment. Action to prevent and treat diabetes may contribute to the fight against depressive symptoms, especially in the lower-education population.
合并糖尿病和抑郁症较为常见；然而，关于教育对这种关联的影响的证据很少。本研究旨在探讨教育在中国糖尿病对抑郁症状的影响中的作用。
我们使用了中国健康与退休纵向研究的数据，该研究包括了 6921 名在三个队列研究波次中均无抑郁症状的参与者。我们根据流行病学研究中心抑郁量表评估抑郁症状。我们拟合了 Cox 比例风险回归模型来检验基线糖尿病对随后抑郁症状的影响。
与非糖尿病患者相比，仅在 45-64 岁年龄组中，被诊断患有糖尿病的参与者更有可能出现抑郁症状，风险比为 1.30（95%CI：1.05，1.61）。此外，被诊断患有糖尿病对抑郁症状的影响仅发生在具有小学及以下学历的参与者中。
信息缺失可能会提供额外的解释力。
我们的研究结果表明，被诊断患有糖尿病是导致抑郁症状发生的慢性应激源，而个体的教育程度决定了对这种应激源的反应。预防和治疗糖尿病的措施可能有助于对抗抑郁症状，特别是在教育程度较低的人群中。
