墨西哥成年人 2 型糖尿病与抑郁症状：基于全国健康和营养调查的综合征方法
Type 2 diabetes and depressive symptoms in the adult population in Mexico: a syndemic approach based on National Health and Nutrition Survey.
机构信息
Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Instituto Nacional de Geriatría, Mexico City, Mexico.
出版信息
BMC Public Health. 2022 Nov 9;22(1):2049. doi: 10.1186/s12889-022-14405-0.
BACKGROUND
The syndemic approach allows the analysis of clusters of diseases that affect a population in contexts of geographic, social and economic inequalities at the same moment and time. This study aims to analyze, from a syndemic perspective, the relationship between type 2 diabetes (T2D) and depressive symptoms in Mexican adults and its association with individual, contextual and structural factors.
METHODS
Observational, cross-sectional study based on secondary data from Mexico's National Health and Nutrition Survey 2018-19. The sample of this study consisted of 16 835 adults, which represented a total of 78 463 734 persons aged ≥ 20 years. Bivariate descriptive analyses were performed and logistic regression models were estimated to analyze the association between T2D and depressive symptoms with various co-variables. In addition, interactions between T2D and depressive symptoms with obesity, educational level, and socioeconomic status were tested.
RESULTS
In the study population, 12.2% of adults aged 20 years and older self-reported having T2D, 14.7% had depressive symptoms and 2.8% had both diseases. There was a statistically significant relationship between T2D and depressive symptoms. The prevalence of T2D and depressive symptoms was higher compared to people who did not have these two conditions. Obesity increased the probability of having T2D, while violence was statistically associated with people having depressive symptoms. A low level of education increased the odds ratio of having T2D and depressive symptoms.
CONCLUSION
The availability of analytical frameworks such as the syndemic perspective could help to identify areas of opportunity for decision making and actions for population groups that-because of their individual, contextual and structural disadvantages-are at greater risk of experiencing poorer health outcomes due to the presence of T2D and depressive symptoms.
背景
综合征方法允许在地理、社会和经济不平等的背景下，同时分析影响人群的疾病集群。本研究旨在从综合征的角度分析墨西哥成年人 2 型糖尿病（T2D）和抑郁症状之间的关系，以及它们与个体、环境和结构因素的关系。
方法
这是一项基于 2018-19 年墨西哥国家健康和营养调查的二次数据的观察性、横断面研究。本研究的样本由 16835 名成年人组成，代表了总共 78463734 名年龄≥20 岁的人。进行了双变量描述性分析，并估计了逻辑回归模型，以分析 T2D 和抑郁症状与各种协变量之间的关联。此外，还测试了 T2D 和抑郁症状与肥胖、教育水平和社会经济地位之间的相互作用。
结果
在研究人群中，12.2%的 20 岁及以上成年人自我报告患有 T2D，14.7%患有抑郁症状，2.8%同时患有这两种疾病。T2D 和抑郁症状之间存在统计学上的显著关系。患有 T2D 和抑郁症状的人比没有这两种疾病的人更普遍。肥胖增加了患有 T2D 的可能性，而暴力则与患有抑郁症状的人有统计学上的关联。教育程度低增加了患有 T2D 和抑郁症状的几率。
结论
诸如综合征视角等分析框架的可用性可以帮助确定决策和行动的机会领域，这些机会领域针对的是由于个体、环境和结构劣势而处于更大风险的人群，因为他们存在 T2D 和抑郁症状，因此健康状况较差的风险更高。
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