West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Diabetes Complications. 2019 Oct;33(10):107387. doi: 10.1016/j.jdiacomp.2019.05.018. Epub 2019 May 29.
To prospectively examine the bidirectional relationship between depressive symptoms and type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese.
Participants were enrolled in 2011-2012 (Wave 1) and followed up in 2013-2014 (Wave 2) and 2015-2016 (Wave 3) in the China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated by the Chinese language version of 10-item Center for Epidemiological Studies Depression Scale (CESD-10) at three waves. T2DM was assessed by biochemical biomarkers at Wave 1 and reported physician-diagnosis at Wave 2 and 3. Cox proportional hazards regression was applied to calculate hazard ratio (HR) and 95% confidence intervals (CIs) for the bidirectional association.
Participants with baseline depressive symptoms were 1.33 times as likely to develop T2DM (HR, 1.33; 95% CI: 1.06, 1.66), compared to their counterparts after adjusting for demographic characteristics and T2DM risk factors. The risk of T2DM increased linearly with higher severity of depression as determined by a higher CESD-10 score (P for trend ≪ 0.001). In addition, baseline T2DM was associated with increased risk of incident depressive symptoms (1.15; 1.00, 1.31) and persistent depressive symptoms (1.35; 1.03, 1.77).
There is a positive bidirectional association between depressive symptoms and T2DM in middle-aged and elderly Chinese.
前瞻性地研究中老年中国人抑郁症状与 2 型糖尿病（T2DM）之间的双向关系。
参与者于 2011-2012 年（第 1 波）入组，并于 2013-2014 年（第 2 波）和 2015-2016 年（第 3 波）进行随访，随访来自中国健康与退休纵向研究。在 3 个时间点使用中文 10 项流行病学研究抑郁量表（CESD-10）评估抑郁症状。第 1 波采用生化标志物评估 T2DM，第 2 波和第 3 波采用医生诊断报告 T2DM。应用 Cox 比例风险回归计算双向关联的风险比（HR）和 95%置信区间（CI）。
与没有基线抑郁症状的参与者相比，有基线抑郁症状的参与者发展为 T2DM 的可能性高 33%（HR，1.33；95%CI：1.06，1.66），校正人口统计学特征和 T2DM 危险因素后结果仍然如此。根据 CESD-10 评分（P趋势<0.001），抑郁严重程度越高，T2DM 的风险呈线性增加。此外，基线 T2DM 与新发抑郁症状（1.15；1.00，1.31）和持续抑郁症状（1.35；1.03，1.77）的风险增加相关。
在中国中老年人群中，抑郁症状与 T2DM 之间存在正向双向关联。
