Lengton Robin, W Schouten Robbert, Nadort Els, van Rossum Elisabeth Fc, Dekker Friedo W, Siegert Carl Eh, Hoogeveen Ellen K
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Nephrology, OLVG hospital, Amsterdam, The Netherlands.
Clin Med Insights Endocrinol Diabetes. 2022 Aug 29;15:11795514221119446. doi: 10.1177/11795514221119446. eCollection 2022.
Depression is associated with lower quality of life and increased risk of mortality. The prevalence of depression in chronic dialysis patients, as well as in patients with diabetes, is more than 20%. It is debated whether use of beta-blockers increases the risk of depression. Therefore, we examined in chronic dialysis patients with and without diabetes, the association between beta-blockers and depressive symptoms.
Data were collected from the DIVERS-I study, a multicentre prospective cohort among chronic dialysis patients in the Netherlands. Depressive symptoms were assessed with the Beck Depression Inventory (BDI-II). We defined depressive symptoms as a BDI-II score ⩾16. The cross-sectional association at baseline between depressive symptoms and beta-blocker use in chronic dialysis patients, was studied by multivariable logistic regression adjusted for potential confounders.
We included 684 chronic dialysis patients, of whom 43% had diabetes mellitus, and 57% used a beta-blocker of which 97% were lipophilic. After multivariable adjustment, the OR (95% CI) for depressive symptoms in patients with compared to without diabetes was 1.41 (1.00-1.98), and in beta-blocker users compared to non-users 1.12 (0.80-1.56), respectively. Dialysis patients with diabetes and beta-blocker use compared to those without diabetes and not using beta-blockers had an OR of 1.73 (1.12-2.69) for depressive symptoms. The association was stronger in dialysis patients with diabetes and lipophilic beta-blocker use with an OR of 1.77 (1.14-2.74).
We found a possible association between lipophilic beta-blocker use and depressive symptoms in chronic dialysis patients with diabetes.
抑郁症与生活质量降低及死亡风险增加相关。慢性透析患者以及糖尿病患者中抑郁症的患病率超过20%。β受体阻滞剂的使用是否会增加抑郁症风险存在争议。因此，我们在患有和未患糖尿病的慢性透析患者中，研究了β受体阻滞剂与抑郁症状之间的关联。
数据收集自DIVERS-I研究，这是一项针对荷兰慢性透析患者的多中心前瞻性队列研究。使用贝克抑郁量表（BDI-II）评估抑郁症状。我们将抑郁症状定义为BDI-II评分≥16。通过对潜在混杂因素进行调整的多变量逻辑回归，研究慢性透析患者基线时抑郁症状与β受体阻滞剂使用之间的横断面关联。
我们纳入了684例慢性透析患者，其中43%患有糖尿病，57%使用β受体阻滞剂，其中97%为亲脂性药物。经过多变量调整后，患有糖尿病与未患糖尿病患者出现抑郁症状的比值比（95%可信区间）为1.41（1.00 - 1.98），使用β受体阻滞剂与未使用者的比值比为1.12（0.80 - 1.56）。与未患糖尿病且未使用β受体阻滞剂的患者相比，患有糖尿病且使用β受体阻滞剂的透析患者出现抑郁症状的比值比为1.73（1.12 - 2.69）。在患有糖尿病且使用亲脂性β受体阻滞剂的透析患者中，这种关联更强，比值比为1.77（1.14 - 2.74）。
我们发现，在患有糖尿病的慢性透析患者中，使用亲脂性β受体阻滞剂与抑郁症状之间可能存在关联。
