Center for Primary Health Care Research, Lund University, Lund, Sweden.
Department of Clinical Microbiology, Center of Diagnostic Investigations, Copenhagen University Hospital, Rigshospitalet, Denmark.
Stress Health. 2024 Apr;40(2):e3302. doi: 10.1002/smi.3302. Epub 2023 Aug 10.
Patients with bipolar disorder have higher rates of type 2 diabetes (T2D) compared to the general population. Neighbourhood deprivation is associated with T2D and bipolar disorder. The aim of this study was to explore the potential effect of neighbourhood deprivation on incident T2D in patients with bipolar disorder. This nationwide open cohort study (1997-2018) included adults in Sweden ≥20 years with bipolar disorder (90,780 patients) to examine the subsequent risk of T2D. The association between neighbourhood deprivation and T2D was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for individual-level sociodemographic factors and comorbidities. Neighbourhood deprivation was significantly associated with T2D in patients with bipolar disorder. The HRs were 1.61 (95% CI 1.40-1.86) for men and 1.83 (1.60-2.10) for women living in high deprivation neighbourhoods compared to those from low deprivation neighbourhoods. After adjustment, these results remained significant: 1.35 (1.17-1.56) in men and 1.39 (1.20-1.60) in women living in high deprivation neighbourhoods. The suggested graded association of higher incident T2D among patients with bipolar disorder, observed when levels of neighbourhood deprivation increased, raises important clinical and public health concerns. The results may help develop a contextual approach to prevention of T2D in patients with bipolar disorder that includes the neighbourhood environment.
与一般人群相比，双相情感障碍患者 2 型糖尿病（T2D）的发病率更高。邻里贫困与 T2D 和双相情感障碍有关。本研究旨在探讨邻里贫困对双相情感障碍患者 T2D 发病的潜在影响。这是一项全国性的开放队列研究（1997-2018 年），纳入了瑞典≥20 岁的双相情感障碍患者（90780 例），以检查 T2D 的后续发病风险。使用 Cox 回归分析探讨了邻里贫困与 T2D 之间的关联，使用风险比（HRs）和 95%置信区间（95%CI）。所有模型均在男性和女性中进行，并调整了个体社会人口统计学因素和合并症。在双相情感障碍患者中，邻里贫困与 T2D 显著相关。与居住在低贫困社区的患者相比，居住在高贫困社区的男性 HR 为 1.61（95%CI 1.40-1.86），女性 HR 为 1.83（1.60-2.10）。调整后，这些结果仍然显著：男性为 1.35（1.17-1.56），女性为 1.39（1.20-1.60）。当邻里贫困程度增加时，双相情感障碍患者中 T2D 发病率呈递增趋势，这一结果引起了重要的临床和公共卫生关注。这些结果可能有助于制定针对双相情感障碍患者 T2D 的预防的情境方法，包括邻里环境。
