2型糖尿病微血管并发症对认知障碍和抑郁的患病率及影响：一项系统评价和荟萃分析
Prevalence and impact of microvascular complications in type 2 diabetes mellitus on cognitive impairment and depression: a systematic review and meta-analysis.
作者信息
Satapathy Prakasini, Pratima Pandey, Gaidhane Abhay M, Vadia Nasir, Menon Soumya V, Chennakesavulu Kattela, Panigrahi Rajashree, Shabil Muhammed, Jena Diptismita, Kumar Harish, Rani Anju, Sah Sanjit, Singh Mahendra Pratap, Mawejje Edward, Bushi Ganesh
机构信息
Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospital, Saveetha University, Chennai, India.
Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia.
出版信息
Diabetol Metab Syndr. 2025 Jun 3;17(1):187. doi: 10.1186/s13098-025-01759-9.
BACKGROUND
Type 2 diabetes mellitus (T2DM) is a global health burden, often leading to microvascular complications such as neuropathy, retinopathy, and nephropathy. These complications may contribute to cognitive impairment and depression, further complicating disease management and adversely affecting quality of life. This systematic review and meta-analysis aimed to assess the prevalence and association between diabetic microvascular complications and cognitive impairment and depression among individuals with T2DM.
METHODS
A systematic search of PubMed, Embase, and Web of Science was conducted through November 15, 2024, following PRISMA guidelines. Observational studies examining the association between microvascular complications and mental health outcomes were included. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) scale. Meta-analyses were performed using standard statistical software, with pooled odds ratios (ORs) and 95% confidence intervals (CIs) calculated.
RESULTS
Out of 5,640 articles screened, 7 studies met inclusion criteria. The prevalence of cognitive impairment was 34.9% in patients with neuropathy, 55.29% with retinopathy, and 40.97% with nephropathy. Depression prevalence was 43.30% for neuropathy, 40.17% for retinopathy, and 18.92% for nephropathy. Associations with cognitive impairment showed ORs of 0.878 (95% CI, 0.298-2.585) for neuropathy, 1.358 (95% CI, 0.957-1.927) for retinopathy, and 1.421 (95% CI, 1.086-1.858) for nephropathy. For depression, ORs were 1.291 (95% CI, 0.613-2.721) for retinopathy and 6.200 (95% CI, 0.029-1305.771) for neuropathy.
CONCLUSION
Microvascular complications in T2DM contribute substantially to the burden of cognitive impairment and depression, with nephropathy showing a particularly strong link to cognitive decline. Standardized assessment approaches are needed, and integrated mental health care should be prioritized in the management of individuals with diabetes.
CLINICAL TRIAL NUMBER
Not applicable.
背景
2型糖尿病（T2DM）是一项全球性的健康负担，常导致微血管并发症，如神经病变、视网膜病变和肾病。这些并发症可能导致认知障碍和抑郁，使疾病管理更加复杂，并对生活质量产生不利影响。本系统评价和荟萃分析旨在评估T2DM患者中糖尿病微血管并发症与认知障碍和抑郁之间的患病率及关联。
方法
按照PRISMA指南，截至2024年11月15日，对PubMed、Embase和Web of Science进行了系统检索。纳入了考察微血管并发症与心理健康结局之间关联的观察性研究。使用非随机研究方法学指数（MINORS）量表评估研究质量。使用标准统计软件进行荟萃分析，计算合并比值比（OR）和95%置信区间（CI）。
结果
在筛选的5640篇文章中，7项研究符合纳入标准。神经病变患者的认知障碍患病率为34.9%，视网膜病变患者为55.29%，肾病患者为40.97%。神经病变患者的抑郁患病率为43.30%，视网膜病变患者为40.17%，肾病患者为18.92%。与认知障碍的关联显示，神经病变的OR为0.878（95%CI，0.298 - 2.585），视网膜病变为1.358（95%CI，0.957 - 1.927），肾病为1.421（95%CI，1.086 - 1.858）。对于抑郁，视网膜病变的OR为1.291（95%CI，0.613 - 2.721），神经病变为6.200（95%CI，0.029 - 1305.771）。
结论
T2DM中的微血管并发症在很大程度上导致了认知障碍和抑郁的负担，肾病与认知衰退的联系尤为紧密。需要标准化的评估方法，并且在糖尿病患者的管理中应优先考虑综合心理健康护理。
临床试验编号
不适用。
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