血清25-羟基维生素D与糖尿病前期和糖尿病患者抑郁风险的关联：一项前瞻性队列研究。
Association of serum 25-hydroxyvitamin D with the risk of depression in individuals with prediabetes and diabetes: A prospective cohort study.
作者信息
Li Huaxue, Liu Guodong, Ma Yicheng, Shi Yingzhou, Han Junming, Tian Shengyu, Dong Hang, Wang Peipei, Lu Yingli, Wang Qiang, Gao Ling, Cheng Yiping
机构信息
Department of Endocrinology, Shandong Provincial Hospital, Shandong University; Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Jinan, Shandong, 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, 250021, China; "Chuangxin China" Innovation Base of stem cell and Gene Therapy for endocrine Metabolic diseases; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, 250021, China.
Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, 250021, China; "Chuangxin China" Innovation Base of stem cell and Gene Therapy for endocrine Metabolic diseases; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, 250021, China.
出版信息
J Nutr Health Aging. 2025 Jun;29(6):100556. doi: 10.1016/j.jnha.2025.100556. Epub 2025 Apr 14.
OBJECTIVE
Serum 25-hydroxyvitamin D [25(OH)D] is known to be associated with depression. However, the evidence concerning the association between vitamin D status and depressive episodes in population with prediabetes and diabetes remains limited. This study seeks to investigate the potential relationship between vitamin D levels and depression in this population.
METHODS
This cohort study comprised 55,252 individuals with prediabetes and 17,369 patients with diabetes, who exhibited no signs of depression at baseline. Baseline 25(OH)D concentrations were assessed. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% CIs for depression, with adjustments made for potential confounding variables.
RESULTS
Over a mean follow-up period of 11.7 years, a total of 2,409 depression events were documented in participants with diabetes; and 6,078 depression events were recorded in the prediabetic participants, during a mean follow-up of 12.3 years. Vitamin D sufficiency (≥75 nmol/L) was observed in only 12.5% of individuals with prediabetes and 11.3% of those with diabetes. After multivariate adjustment, an inverse and dose-dependent relationship was identified between serum 25(OH)D concentrations and the risk of depression in prediabetic and diabetic participants (P trend <0.05). Compared with the lowest 25(OH)D level (<25 nmol/L), the highest level (≥75 nmol/L) exhibited a 17% reduction in the risk of depressive events (HR 0.83; 95% CI 0.75-0.93) among individuals with prediabetes and a 25% reduction (HR 0.75; 95% CI 0.61-0.90) among those with diabetes。 CONCLUSION: The findings of this study highlight the critical importance of prioritizing serum 25(OH)D levels in the management of depression in patients with diabetes and prediabetes.
目的
血清25-羟维生素D[25(OH)D]与抑郁症有关。然而，关于糖尿病前期和糖尿病患者维生素D状态与抑郁发作之间关联的证据仍然有限。本研究旨在调查该人群中维生素D水平与抑郁症之间的潜在关系。
方法
这项队列研究包括55252名糖尿病前期个体和17369名糖尿病患者，他们在基线时均无抑郁迹象。评估了基线25(OH)D浓度。采用Cox比例风险模型估计抑郁症的风险比(HRs)和95%置信区间，并对潜在混杂变量进行了调整。
结果
在平均11.7年的随访期内，糖尿病患者中共记录到2409例抑郁事件；在糖尿病前期参与者平均12.3年的随访期间，记录到6078例抑郁事件。仅12.5%的糖尿病前期个体和11.3%的糖尿病患者维生素D充足(≥75 nmol/L)。多变量调整后，在糖尿病前期和糖尿病参与者中，血清25(OH)D浓度与抑郁风险之间存在负相关且呈剂量依赖关系(P趋势<0.05)。与最低25(OH)D水平(<25 nmol/L)相比，最高水平(≥75 nmol/L)在糖尿病前期个体中抑郁事件风险降低了17%(HR 0.83；95%CI 0.75-0.93)，在糖尿病患者中降低了25%(HR 0.75；95%CI 0.61-0.90)。结论：本研究结果强调了在糖尿病和糖尿病前期患者抑郁症管理中优先考虑血清25(OH)D水平的至关重要性。
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