Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, U.K.
Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K.
Diabetes Care. 2019 Oct;42(10):1865-1872. doi: 10.2337/dc19-0813. Epub 2019 Aug 15.
We tested whether inflammation is associated with worsening depressive symptoms in type 2 diabetes and examined whether sex moderated this association.
In a prospective cohort study of people with newly diagnosed type 2 diabetes, we measured depressive symptoms over a 2-year follow-up using the Patient Health Questionnaire-9 (PHQ-9). The independent variable was a composite inflammation burden score at diagnosis of diabetes, derived from hs-CRP, white cell count, interleukin (IL)-1β, IL-1 receptor antagonist, monocyte chemotactic protein-1, and vascular endothelial growth factor concentrations. General linear models assessed ) the association between overall inflammation burden and estimated marginal mean PHQ-9 score (ln transformed) at 2 years and ) whether sex interacted with elevated inflammation burden (above-median score) in predicting change in PHQ-9 score. Models were adjusted for age, ethnicity, BMI, blood pressure, cholesterol, HbA, antidepressants, anti-inflammatory medications, and baseline ln PHQ-9 score.
Of 1,174 people with complete inflammation data, mean (SD) age was 56.7 (11.0) years and 46.1% were of nonwhite ethnicity and 44.1% female. After full adjustment, inflammation burden was not associated with worsening ln PHQ-9 score ( = 0.65). However, female sex interacted with elevated inflammation in predicting higher 2-year ln PHQ-9 score (β = 0.32, = 0.005), showing that the difference by inflammation burden in females was 0.32 larger than in males. In post hoc comparisons, ln PHQ-9 score was higher in females than males with elevated inflammation ( = 0.003) but not with low inflammation ( = 0.34) burden.
In type 2 diabetes, female sex confers specific vulnerability to the effects of inflammation on depressive symptoms.
我们检测炎症是否与 2 型糖尿病患者的抑郁症状恶化相关，并探讨性别是否调节了这种关联。
在一项新诊断为 2 型糖尿病患者的前瞻性队列研究中，我们使用患者健康问卷-9（PHQ-9）在 2 年的随访中测量抑郁症状。自变量是糖尿病诊断时炎症负担综合评分，由 hs-CRP、白细胞计数、白细胞介素 (IL)-1β、IL-1 受体拮抗剂、单核细胞趋化蛋白-1 和血管内皮生长因子浓度得出。一般线性模型评估）整体炎症负担与 2 年时 PHQ-9 评分（ln 转换）的估计边际均值之间的关系）性别是否与升高的炎症负担（高于中位数的评分）相互作用，预测 PHQ-9 评分的变化。模型调整了年龄、种族、BMI、血压、胆固醇、HbA、抗抑郁药、抗炎药和基线 ln PHQ-9 评分。
在 1174 名具有完整炎症数据的患者中，平均（SD）年龄为 56.7（11.0）岁，46.1%为非白人种族，44.1%为女性。经过充分调整，炎症负担与恶化的 ln PHQ-9 评分无关（ = 0.65）。然而，女性性别与升高的炎症相互作用，预测更高的 2 年 ln PHQ-9 评分（β = 0.32， = 0.005），表明炎症负担对女性的影响比男性大 0.32。在事后比较中，ln PHQ-9 评分在炎症升高的女性中高于男性（ = 0.003），但在炎症负担低的女性中则没有（ = 0.34）。
在 2 型糖尿病中，女性性别使炎症对抑郁症状的影响具有特定的易感性。
