Ye Man-Li, Wang Jie-Ke
Department of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
Department of Hand and Plastic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
World J Clin Cases. 2024 Jun 26;12(18):3428-3437. doi: 10.12998/wjcc.v12.i18.3428.
Individuals with diabetes mellitus are more likely to experience depression, although most patients remain undiagnosed. The relation between total bilirubin and depression has been increasingly discussed, but limited studies have examined the association of total bilirubin with depression risk in adults with diabetes, which warrants attention.
To investigate the association between total bilirubin levels and the risk of depression in adults with diabetes.
The study included adults with diabetes from the National Health and Nutrition Examination Survey 2007-2018. Depression was determined using the Patient Health Questionnaire-9. Multivariable logistic regression, propensity score-matched analysis and restricted cubic spline models were utilized to investigate the association between total bilirubin levels and depression risk in adults with diabetes.
The study included 4758 adults with diabetes, of whom 602 (12.7%) were diagnosed with depression. After adjusting for covariates, we found that diabetic adults with lower total bilirubin levels had a higher risk of depression (OR = 1.230, 95%CI: 1.006-1.503, = 0.043). This association was further confirmed after propensity score matching (OR = 1.303, 95%CI: 1.034-1.641, = 0.025). Subgroup analyses showed no significant dependence of age, body mass index, sex, race or hypertension on this association. Restricted cubic spline models displayed an inverted U-shaped association of total bilirubin levels with depression risk within the lower range of total bilirubin levels. The depression risk heightened with the increasing levels of total bilirubin, reaching the highest risk at 6.81 μmol/L and decreasing thereafter.
In adults with diabetes, those with lower levels of total bilirubin were more likely to have depressive symptoms. Serum total bilirubin levels may be used as an additional indicator to assess depression risk in adults with diabetes.
糖尿病患者更易患抑郁症，尽管大多数患者仍未被诊断出来。总胆红素与抑郁症之间的关系已得到越来越多的讨论，但针对糖尿病成年人中总胆红素与抑郁症风险之间关联的研究有限，这值得关注。
探讨糖尿病成年人总胆红素水平与抑郁症风险之间的关联。
该研究纳入了2007 - 2018年美国国家健康与营养检查调查中的糖尿病成年人。使用患者健康问卷-9来确定是否患有抑郁症。采用多变量逻辑回归、倾向得分匹配分析和受限立方样条模型来研究糖尿病成年人总胆红素水平与抑郁症风险之间的关联。
该研究纳入了4758名糖尿病成年人，其中602人（12.7%）被诊断为患有抑郁症。在调整协变量后，我们发现总胆红素水平较低的糖尿病成年人患抑郁症的风险更高（比值比 = 1.230，95%置信区间：1.006 - 1.503，P = 0.043）。倾向得分匹配后，这种关联得到进一步证实（比值比 = 1.303，95%置信区间：1.034 - 1.641，P = 0.025）。亚组分析表明，年龄、体重指数、性别、种族或高血压对此关联无显著依赖性。受限立方样条模型显示，在总胆红素水平较低的范围内，总胆红素水平与抑郁症风险呈倒U形关联。抑郁症风险随着总胆红素水平的升高而增加，在6.81μmol/L时达到最高风险，此后降低。
在糖尿病成年人中，总胆红素水平较低者更易出现抑郁症状。血清总胆红素水平可作为评估糖尿病成年人抑郁症风险的一项附加指标。
