School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia.
School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia; Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle 2305, NSW, Australia.
J Psychosom Res. 2022 Nov;162:110991. doi: 10.1016/j.jpsychores.2022.110991. Epub 2022 Jul 21.
Due to the existence of inconsistencies in the evidence regarding the direction and extent of association between diabetes and anxiety disorders, the anxiety-diabetes comorbidity remains an issue of debate.
To estimate the proportion and risk of diabetes among individuals with anxiety disorder and vice versa.
A systematic review was conducted using studies retrieved from databases and grey literature, with the last database search being conducted on April 15, 2021. The methodological rigor of studies was assessed using the National Institute of Health quality assessment tool. Prevalence and effect size (ES) estimates were pooled using a random effect model. Heterogeneity was assessed using the Higgins' I statistical test, and subgroup analysis conducted.
We included 68 studies presenting data from 2,128,029 participants. The prevalence of anxiety disorders in diabetic patients was 28% (95% CI: 26%, 31%); however, subgroup analysis showed significant differences based on type of anxiety assessment scales, study location, and type of diabetes. The prevalence of diabetes among patients with anxiety disorders was 12% (95% CI: 9%, 16%). Patients with anxiety disorders were found to have a 19% higher risk of diabetes (pooled effect size (ES) = 1.19, 95% CI: 1.13, 1.26). Diabetic patients were found to have a 41% higher risk of developing anxiety disorders (ES = 1.41, 95% CI: 1.19, 1.62).
There is a higher risk of anxiety disorders in patients with diabetes mellitus and vice versa. It is recommended to screen diabetic patients for anxiety at initial diagnosis and follow-up visits. Similarly, patients with anxiety disorders should have regular screening for diabetes.
PROSPERO registration number CRD42021252475.
由于糖尿病与焦虑障碍之间关联的方向和程度的证据存在不一致，焦虑-糖尿病共病仍然是一个有争议的问题。
估计患有焦虑障碍和反之患有糖尿病的个体中糖尿病的比例和风险。
使用从数据库和灰色文献中检索到的研究进行系统评价，最后一次数据库搜索于 2021 年 4 月 15 日进行。使用国家卫生研究院质量评估工具评估研究的方法学严谨性。使用随机效应模型汇总患病率和效应量（ES）估计值。使用 Higgins' I 统计检验评估异质性，并进行亚组分析。
我们纳入了 68 项研究，这些研究提供了来自 2128029 名参与者的数据。糖尿病患者中焦虑障碍的患病率为 28%（95%CI：26%，31%）；然而，亚组分析显示基于焦虑评估量表的类型、研究地点和糖尿病的类型存在显著差异。患有焦虑障碍的患者中糖尿病的患病率为 12%（95%CI：9%，16%）。患有焦虑障碍的患者患糖尿病的风险高 19%（合并效应量（ES）=1.19，95%CI：1.13，1.26）。患有糖尿病的患者患焦虑障碍的风险高 41%（ES=1.41，95%CI：1.19，1.62）。
糖尿病患者和反之患有焦虑障碍的风险较高。建议在初始诊断和随访时筛查糖尿病患者的焦虑症，同样，患有焦虑障碍的患者应定期筛查糖尿病。
PROSPERO 注册号 CRD42021252475。
