Department of Endocrinology, People's Hospital of Longhua, Shenzhen, China.
Department of Endocrinology, The Second People's Hospital of Shenzhen, Shenzhen, China.
BMJ Open. 2018 Nov 28;8(11):e020062. doi: 10.1136/bmjopen-2017-020062.
Several patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.
A meta-analysis.
We conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed.
Twenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data.
Our meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.
一些 2 型糖尿病（T2DM）患者患有抑郁症。胰岛素治疗是否与增加抑郁风险相关仍存在争议。我们进行了一项荟萃分析，以评估胰岛素治疗与抑郁之间的关系。
荟萃分析。
我们对 PubMed、PsycINFO、Embase 和 Cochrane Library 进行了系统检索，检索时间从建库至 2016 年 4 月。纳入比较胰岛素使用者和非胰岛素使用者之间抑郁患病率的流行病学研究。采用随机效应模型进行荟萃分析。分析调整后和未调整数据。
共纳入 28 项研究。其中，12 项研究提供了调整后的 OR。胰岛素治疗与抑郁风险增加显著相关（OR=1.41，95%CI 1.13 至 1.76，p=0.003）。24 项研究提供了未调整数据。胰岛素治疗也与发生抑郁的几率相关（OR=1.59，95%CI 1.41 至 1.80，p<0.001）。当比较胰岛素治疗与口服抗糖尿病药物时，调整后（OR=1.42，95%CI 1.08 至 1.86，p=0.008）和未调整（OR=1.61，95%CI 1.35 至 1.93，p<0.001）数据均显示出显著关联。
我们的荟萃分析证实，接受胰岛素治疗的患者与发生抑郁症状的风险显著相关。
