An Ji Hyun, Han Kyung-do, Jeon Hong Jin
Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
Front Psychiatry. 2023 Jul 24;14:1217104. doi: 10.3389/fpsyt.2023.1217104. eCollection 2023.
While variabilities in metabolic parameters (METv) have been linked to adverse health outcomes in type 2 DM, their association with depression is yet to be studied. This research aimed to investigate the association between METv and depressive disorder in patients with type 2 DM.
The study involved a nationwide cohort of 1,119,631 type 2 DM patients who had undergone three or more serial health examinations between 2005 and 2012. At each visit, body mass index (BMI), fasting glucose (FG), systolic blood pressure (BP), and total cholesterol (TC) were measured and stratified into quartiles, with Q4 being the highest and Q1 the lowest. The risk of depressive disorder was evaluated using Cox proportional hazard regression models, which accounted for METs in the indexes, after adjusting for sex, income status, lifestyle habits, medical comorbidities, DM severity, and baseline levels of BMI, FG, BP, and TC.
During a mean follow-up period of 6.00 ± 2.42 years, 239,477 (21.4%) cases of type 2 DM patients developed depressive disorder. The risk of developing depressive disorder was gradually increased as the number of METv increased (HR 1.18; 95% CI 1.13, 1.23 for the group with the highest METv in all parameters compared to those with the lowest METv in all parameters). In the subgroup analysis, the risk of developing depressive disorder was 43% higher in men (HR 1.43; 95% CI 1.34, 1.51), and 31% higher in those younger than 65 years of age (HR 1.31; 95% CI 1.23, 1.39) in the group with the highest number of METv compared to the group with the lowest number of METv.
In type 2 DM, higher METv was an independent risk factor for depressive disorder. This risk is notably elevated in men and individuals under the age of 65 years.
虽然代谢参数变异性（METv）与2型糖尿病患者不良健康结局相关，但其与抑郁症的关联尚未得到研究。本研究旨在探讨2型糖尿病患者中METv与抑郁症之间的关联。
该研究纳入了2005年至2012年间在全国范围内接受过三次或更多次连续健康检查的1,119,631例2型糖尿病患者队列。每次就诊时，测量体重指数（BMI）、空腹血糖（FG）、收缩压（BP）和总胆固醇（TC），并将其分层为四分位数，Q4为最高，Q1为最低。在调整了性别、收入状况、生活习惯、合并症、糖尿病严重程度以及BMI、FG、BP和TC的基线水平后，使用Cox比例风险回归模型评估抑郁症风险，该模型在指数中考虑了METs。
在平均6.00±2.42年的随访期内，239,477例（21.4%）2型糖尿病患者发生了抑郁症。随着METv数量的增加，发生抑郁症的风险逐渐升高（与所有参数中METv最低的组相比，所有参数中METv最高的组的HR为1.18；95%CI为1.13,1.23）。在亚组分析中，与METv数量最低的组相比，METv数量最高的组中男性发生抑郁症的风险高43%（HR为1.43；95%CI为1.34,1.51），65岁以下人群发生抑郁症的风险高31%（HR为1.31；95%CI为1.23,1.39）。
在2型糖尿病中，较高的METv是抑郁症的独立危险因素。这种风险在男性和65岁以下个体中显著升高。
