Department of Health Statistics, Second Military Medical University, Shanghai, China.
School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Diabet Med. 2021 May;38(5):e14375. doi: 10.1111/dme.14375. Epub 2020 Sep 19.
To evaluate the relationship between newly diagnosed diabetes or prediabetes and depressive symptoms among individuals with risk factors for diabetes in China. We also investigated the associations of depressive symptoms with pancreatic β-cell function and insulin resistance.
We used cross-sectional data from the Shanghai High-Risk Diabetic Screen (SHiDS) project. Between 2014 and 2017, a total of 1728 participants were enrolled in this study and underwent an oral glucose tolerance test to screen for diabetes and prediabetes. Insulin resistance was evaluated using the homeostatic model assessment of insulin resistance and the modified Matsuda index. Pancreatic β-cell function was calculated using the homeostatic model assessment of β-cell function, Stumvoll first- and second-phase indexes. Elevated depressive symptoms were determined using the Patient Health Questionnaire-9 (PHQ-9 score ≥ 10).
The prevalence of elevated depressive symptoms in the total study population was 4.8% (83 of 1728). Compared with the normal glucose tolerance group, individuals with newly diagnosed diabetes were less likely to have elevated depressive symptoms even after controlling for potential confounders [adjusted odds ratio (OR) 0.35, 95% confidence interval (CI) 0.18-0.68; P = 0.002]. However, prediabetes was not associated with depressive symptoms. The odds for elevated depressive symptoms were increased in individuals with higher levels of the Stumvoll first-phase index. No association was observed between depressive symptoms and insulin resistance.
Elevated depressive symptoms were less prevalent in Chinese individuals with newly diagnosed diabetes among a high-risk population for diabetes.
评估中国糖尿病高危人群中初诊糖尿病或糖尿病前期与抑郁症状之间的关系。我们还研究了抑郁症状与胰岛β细胞功能和胰岛素抵抗之间的关系。
我们使用了上海高危糖尿病筛查(SHiDS)项目的横断面数据。在 2014 年至 2017 年期间,共有 1728 名参与者纳入本研究,并进行口服葡萄糖耐量试验以筛查糖尿病和糖尿病前期。使用稳态模型评估胰岛素抵抗和改良 Matsuda 指数评估胰岛素抵抗。使用稳态模型评估β细胞功能、Stumvoll 第一和第二阶段指数计算胰岛β细胞功能。使用患者健康问卷-9(PHQ-9 得分≥10)确定抑郁症状升高。
总研究人群中抑郁症状升高的患病率为 4.8%(1728 人中 83 人)。与正常糖耐量组相比,即使在控制了潜在混杂因素后,新诊断为糖尿病的个体发生抑郁症状升高的可能性较小[校正比值比(OR)0.35,95%置信区间(CI)0.18-0.68;P=0.002]。然而,糖尿病前期与抑郁症状无关。Stumvoll 第一阶段指数较高的个体发生抑郁症状升高的几率增加。抑郁症状与胰岛素抵抗之间没有关联。
在糖尿病高危人群中,新诊断为糖尿病的中国个体中,抑郁症状升高的比例较低。