Koning Elena, Grigolon Ruth Bartelli, Breda Vitor, Gomes Fabiano A, Zucatti Kelly P, Teixeira Paula P, Colpani Veronica, Gerchman Fernando, Brietzke Elisa
Centre for Neuroscience Studies (CNS), Queen's University, Kingston, ON, Canada.
Department of Psychiatry, Universidade Federal de São Paulo, Brazil.
J Psychosom Res. 2023 Oct;173:111445. doi: 10.1016/j.jpsychores.2023.111445. Epub 2023 Aug 6.
Type 2 diabetes mellitus (T2DM) is a severe metabolic condition which is commonly comorbid with depression. Lifestyle factors are involved in the pathophysiology of both conditions; however, the role of lifestyle interventions remains unclear.
The objective of this study is to systematically review the literature on randomized controlled trials evaluating the effect of lifestyle interventions on depressive scores in patients with T2DM.
A systematic search was conducted in computerized databases before October 2022. A random-effects model was used to investigate the effect of lifestyle interventions on depression scores and meta-regression was conducted to assess the influence of age and disease onset.
Six trials met the eligibility criteria for inclusion. A statistically significant reduction in depression scores was found for groups receiving lifestyle interventions compared to controls (SMD = -0.49 [95%CI -0.89 to -0.08]; p = 0.0269]). Interventions increased in efficacy with the age of the participants but no significant correlation was found with years since disease onset. Participants in a control group receiving a less intense lifestyle intervention demonstrated improved depression scores when compared to those who received standard care or no intervention at all. Trial design and outcome measurement tools were heterogeneous between studies and limited data on antidepressant use was available which may introduce bias into the results.
Lifestyle interventions were effective at improving depressive symptom severity in patients with T2DM.
2型糖尿病（T2DM）是一种严重的代谢性疾病，常与抑郁症共病。生活方式因素参与了这两种疾病的病理生理过程；然而，生活方式干预的作用仍不明确。
本研究的目的是系统回顾关于评估生活方式干预对T2DM患者抑郁评分影响的随机对照试验的文献。
在2022年10月之前对计算机化数据库进行了系统检索。采用随机效应模型研究生活方式干预对抑郁评分的影响，并进行Meta回归分析以评估年龄和疾病发病时间的影响。
六项试验符合纳入标准。与对照组相比，接受生活方式干预的组抑郁评分有统计学意义的降低（标准化均数差= -0.49 [95%置信区间 -0.89至 -0.08]；p = 0.0269）。干预效果随着参与者年龄的增加而增强，但与疾病发病后的年限未发现显著相关性。与接受标准护理或根本没有干预的参与者相比，接受强度较低的生活方式干预的对照组参与者的抑郁评分有所改善。研究之间的试验设计和结果测量工具存在异质性，且关于抗抑郁药使用的可用数据有限，这可能会给结果带来偏差。
生活方式干预对改善T2DM患者的抑郁症状严重程度有效。
