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患有 2 型糖尿病患者共病抑郁的患病率:大量观察性研究的更新系统评价和荟萃分析。

The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies.

机构信息

Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Acta Diabetol. 2019 Jun;56(6):631-650. doi: 10.1007/s00592-019-01295-9. Epub 2019 Mar 22.

Abstract

AIMS

Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies.

METHODS

MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11".

RESULTS

In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%).

CONCLUSION

Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.

摘要

目的

抑郁症是 2 型糖尿病(T2DM)患者常见的合并症。这些患者未经治疗的抑郁症会对自我护理活动和其他糖尿病并发症产生不利影响。本研究的目的是通过对观察性研究进行荟萃分析来估计 T2DM 患者中抑郁症的患病率。

方法

检索了 MEDLINE、Web of Science、Science Direct 和 Google Scholar 数据库中所有评估 T2DM 患者抑郁症的观察性研究。使用 Medical Subject Heading(MeSH)术语“depression”、“depressive disorder”和“diabetes mellitus”的组合,搜索了 2007 年 1 月至 2018 年 7 月期间发表的相关文章。使用“metaprop program in STATA 11”采用随机效应模型估计加权患病率和 95%CI。

结果

共纳入 248 项研究(共报道了 273 项患病率),共纳入 83020812 名参与者;其中,23245827 名(28%;95%CI 27,29)患有不同严重程度的抑郁障碍。137372 名男性和 134332 名女性分别单独报告了抑郁症的患病率。其中,31396 名男性(23%,95%CI:20,26)和 45673 名女性(34%,95%CI:31,38)患有抑郁症。与全球估计值相比,欧洲(24%)和非洲(27%)的抑郁症患病率较低,但澳大利亚(29%)和亚洲(32%)的患病率较高。美洲的患病率与世界估计值(28%)相等。与老年人相比,年龄小于 65 岁的患者中抑郁症更为常见(31%比 21%)。

结论

我们的研究结果表明,近四分之一的 T2DM 成年人患有抑郁症。鉴于糖尿病患者中抑郁障碍的高患病率,强烈建议对这些患者进行合并症抑郁及其相关危险因素的筛查。

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