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抑郁症中的功能性消化不良:基于人群的队列研究。

Functional dyspepsia in depression: A population-based cohort study.

机构信息

Department of Pediatrics, Far Eastern Memorial Hospital, Taipei, Taiwan.

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.

出版信息

Eur J Clin Invest. 2021 Jun;51(6):e13506. doi: 10.1111/eci.13506. Epub 2021 Feb 18.

Abstract

BACKGROUND

Patients with functional dyspepsia (FD) are more likely to have persistent depression, yet whether depression and antidepressant treatments are associated with subsequent risk of FD remain unclear.

METHODS

Using population-based insurance administrative data of Taiwan, an 11-year historic cohort study was assembled, comparing cases aged 18 and above with the diagnosis of depressive disorder, to a propensity score-matched sample of adults without depression. Incident FD as a primary diagnosis was ascertained. Hazard ratios of FD were calculated using Cox regression models by age, gender, other comorbidities, nonsteroidal anti-inflammatory medications, antidepressants and antidiabetic agents.

RESULTS

A total of 20,197 people with depressive disorder and 20,197 propensity score-matched comparisons without depression were followed up. The incidence of FD was 1.7-fold greater in the depressive cohort than in comparisons (12.9 versus 7.57 per 1000 person-years), with an adjusted hazard ratio (aHR) of 2.16 (95% confidence interval (CI) 1.932.41). Increased risks were significant regardless of comorbidities or medication uses, the highest in the untreated depression group compared to the group without depression, with an aHR of 2.51(95% CI 2.152.93).

CONCLUSIONS

This population-based study showed that patients with depressive disorder are at elevated risk of FD. Antidepressant treatment could reduce the risk of FD.

摘要

背景

功能性消化不良(FD)患者更有可能持续抑郁,但抑郁和抗抑郁治疗是否与随后发生 FD 的风险相关仍不清楚。

方法

利用台湾基于人群的保险行政数据,进行了一项为期 11 年的历史性队列研究,将年龄在 18 岁及以上的患者与诊断为抑郁症的患者进行比较,并与没有抑郁的成年人进行倾向评分匹配样本比较。以原发性 FD 为确诊。使用 Cox 回归模型按年龄、性别、其他合并症、非甾体抗炎药、抗抑郁药和抗糖尿病药计算 FD 的风险比(HR)。

结果

共随访了 20197 名患有抑郁症的患者和 20197 名无抑郁症的倾向评分匹配对照者。抑郁组的 FD 发生率比对照组高 1.7 倍(12.9 比 7.57/1000 人年),调整后的 HR(aHR)为 2.16(95%置信区间(CI)为 1.932.41)。无论是否存在合并症或药物使用,风险增加均具有统计学意义,与无抑郁症患者相比,未经治疗的抑郁症组风险最高,aHR 为 2.51(95%CI 为 2.152.93)。

结论

这项基于人群的研究表明,患有抑郁症的患者发生 FD 的风险增加。抗抑郁治疗可降低 FD 的风险。

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