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抑郁与 2 型糖尿病风险及其社会人口学因素修饰的关联:中国西南部的一项前瞻性队列研究。

Association between depression and risk of type 2 diabetes and its sociodemographic factors modifications: A prospective cohort study in southwest China.

机构信息

Guizhou Center for Disease Control and Prevention, Guiyang, China.

Department of Preventive Medicine, School of Public Health, Zunyi Medical University, Zunyi, China.

出版信息

J Diabetes. 2023 Nov;15(11):994-1004. doi: 10.1111/1753-0407.13453. Epub 2023 Aug 15.

Abstract

BACKGROUND

Depression may be associated with the risk of developing type 2 diabetes. The goal of this study was to explore the association of severe of depression with the risk of type 2 diabetes in adults in Guizhou, China.

METHODS

A 10-year prospective cohort study of 7158 nondiabetes adults aged 18 years or older was conducted in Guizhou, southwest China from 2010 to 2020. The Patient Health Questionnaire-9 (PHQ-9) was used to measure the prevalence of depression. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) of depression and incident type 2 diabetes. A quantile regression (QR) analytical approach were applied to evaluate the associations of PHQ-9 score with plasma glucose values.

RESULTS

A total of 739 type 2 diabetes cases were identified during a median follow-up of 6.59 years. The HR (95% CI) per 1-SD increase for baseline PHQ-9 score was 1.051 (1.021, 1.082) after multivariable adjustment. Compared with participants without depression, those with mild or more advanced depression had a higher risk of incident type 2 diabetes (HR:1.440 [95% CI, 1.095, 1.894]). Associations between depression with type 2 diabetes were suggested to be even stronger among women or participants aged ≥45 years (p < .05). There are significant positive associations of PHQ-9 score with 2-h oral glucose tolerance test blood glucose levels.

CONCLUSION

Depression significantly increased the risk of incident type 2 diabetes, especially in women, participants aged ≥45 years, Han ethnicity, and urban residents. These findings highlighted the importance and urgency of depression health care.

摘要

背景

抑郁可能与 2 型糖尿病的发病风险相关。本研究旨在探讨中国贵州成年人中重度抑郁与 2 型糖尿病发病风险的关系。

方法

采用前瞻性队列研究,对 2010 年至 2020 年在中国西南部贵州省年龄在 18 岁及以上的 7158 名非糖尿病成年人进行了为期 10 年的随访。采用患者健康问卷-9(PHQ-9)来衡量抑郁的患病率。采用 Cox 比例风险模型估计抑郁和新发 2 型糖尿病的风险比(HR)和 95%置信区间(95%CI)。采用分位数回归(QR)分析方法评估 PHQ-9 评分与血浆葡萄糖值之间的关系。

结果

在中位随访 6.59 年期间,共发现 739 例 2 型糖尿病病例。多变量调整后,基线 PHQ-9 评分每增加 1-SD,发生 2 型糖尿病的 HR(95%CI)为 1.051(1.021,1.082)。与无抑郁的参与者相比,轻度或更严重抑郁的参与者发生 2 型糖尿病的风险更高(HR:1.440 [95%CI,1.095,1.894])。在女性或年龄≥45 岁的参与者中,抑郁与 2 型糖尿病之间的关联似乎更强(p<0.05)。PHQ-9 评分与 2 小时口服葡萄糖耐量试验血糖水平呈显著正相关。

结论

抑郁显著增加了 2 型糖尿病的发病风险,尤其是在女性、年龄≥45 岁、汉族和城镇居民中。这些发现强调了抑郁保健的重要性和紧迫性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b3/10667669/d26bf2154ce0/JDB-15-994-g001.jpg

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