糖尿病前期与 2 型糖尿病风险：在莱夫兰队列研究中探究抑郁和焦虑症状的作用。

Prediabetes and the risk of type 2 diabetes: Investigating the roles of depressive and anxiety symptoms in the Lifelines cohort study.

机构信息

School of Psychology, University College Dublin, Dublin, Ireland.

Department of Psychology, Middlesex University London, London, UK.

出版信息

Diabet Med. 2023 Jul;40(7):e15061. doi: 10.1111/dme.15061. Epub 2023 Feb 17.

DOI:10.1111/dme.15061

PMID:36751973

Abstract

AIMS

Depression and anxiety may increase the risk of progressing from prediabetes to type 2 diabetes. The present study examined the interactions between prediabetes status and elevated depressive and anxiety symptoms with the risk of type 2 diabetes.

METHODS

Participants (N = 72,428) were adults aged 40 years and above without diabetes at baseline from the Lifelines Cohort Study (58% female; mean age = 51.4 years). The Mini-International Neuropsychiatric Interview screened for elevated symptoms of major depressive disorder and generalized anxiety disorder. Glycated haemoglobin A1c (HbA ) levels determined prediabetes status at baseline (2007-2013), and HbA and self-reported diabetes diagnoses determined diabetes status at follow-up (2014-2017). Groups were formed for elevated depressive and anxiety symptoms, respectively, and prediabetes status at baseline (elevated depressive/anxiety symptoms with prediabetes, elevated depressive/anxiety symptoms alone, and prediabetes alone), and compared to a reference group (no prediabetes or anxiety/depression) on the likelihood of developing diabetes during the follow-up period.

RESULTS

N = 1300 (1.8%) participants developed diabetes. While prediabetes alone was associated with incident diabetes (OR = 5.94; 95% CI = 5.10-6.90, p < 0.001), the group with combined prediabetes and depressive symptoms had the highest likelihood of developing diabetes over follow-up (OR = 8.29; 95% CI = 5.58-12.32, p < 0.001). Similar results were found for prediabetes and anxiety symptoms (OR = 6.57; 95% CI = 4.62-9.33, p < 0.001), compared to prediabetes alone (OR = 6.09; 95% CI = 5.23-7.11, p < 0.001), though with a smaller effect. The interaction between depressive symptoms and prediabetes was synergistic in age-and-sex adjusted analyses.

CONCLUSIONS

Individuals with elevated depressive, and to some extent anxiety, symptoms in combination with prediabetes may represent a high-risk subgroup for type 2 diabetes.

摘要

目的

抑郁和焦虑可能会增加从糖尿病前期发展为 2 型糖尿病的风险。本研究探讨了糖尿病前期状态与升高的抑郁和焦虑症状与 2 型糖尿病风险之间的相互作用。

方法

参与者（N=72428）为年龄在 40 岁及以上且基线时无糖尿病的 Lifelines 队列研究成年人（58%为女性；平均年龄为 51.4 岁）。使用 Mini-国际神经精神访谈对主要抑郁障碍和广泛性焦虑障碍的升高症状进行筛查。糖化血红蛋白 A1c（HbA ）水平在基线时（2007-2013 年）确定糖尿病前期状态，HbA 和自我报告的糖尿病诊断在随访时（2014-2017 年）确定糖尿病状态。根据基线时升高的抑郁和焦虑症状（分别有抑郁/焦虑症状和糖尿病前期、有抑郁/焦虑症状但无糖尿病前期、仅有糖尿病前期）以及糖尿病前期状态，为升高的抑郁和焦虑症状组形成组，并与随访期间发生糖尿病的可能性相关参考组（无糖尿病前期或无焦虑/抑郁）进行比较。

结果

N=1300（1.8%）参与者发生了糖尿病。虽然单独的糖尿病前期与发生糖尿病相关（OR=5.94；95%CI=5.10-6.90，p<0.001），但同时患有糖尿病前期和抑郁症状的组在随访期间发生糖尿病的可能性最高（OR=8.29；95%CI=5.58-12.32，p<0.001）。对于糖尿病前期和焦虑症状（OR=6.57；95%CI=4.62-9.33，p<0.001）也发现了类似的结果，与单独的糖尿病前期（OR=6.09；95%CI=5.23-7.11，p<0.001）相比，尽管影响较小。在年龄和性别调整分析中，抑郁症状和糖尿病前期之间的相互作用具有协同作用。