Jiménez-Sierra Lucia, Cuadrado-Corrales Natividad, Hernández-Barrera Valentín, Jiménez-Garcia Rodrigo, López-de-Andres Ana, de Miguel-Diez Javier, Bodas-Pinedo Andrés, Zamorano-León José J
Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain.
Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Madrid, Spain.
J Clin Med. 2025 Jun 1;14(11):3895. doi: 10.3390/jcm14113895.
There is a growing body of evidence supporting a bidirectional relationship between depression and type 2 diabetes mellitus (T2DM). The coexistence of depression and T2DM has substantial clinical implications. However, there is little research looking at how these two conditions cluster together in people hospitalized with T2DM, the associated factors, and their effect on hospital outcomes. In this study, we aimed to assess temporal trends in depression prevalence among hospitalized patients with T2DM in Spain from 2017 to 2023. Additionally, we analyzed the association of variables such as gender, age, anxiety, obesity, alcohol and tobacco use, dementia, COVID-19 infection, and personality disorders in the presence of depression among hospitalized T2DM patients and the impact of these variables on in-hospital mortality (IHM). We conducted a population-based cohort study using the Spanish Hospital Discharge Registry (RAE-CMBD). Adults aged ≥ 40 years with a T2DM diagnosis were included. Depression was identified by using ICD-10 codes. Time trends were analyzed by using joinpoint regression. Multivariable logistic regression models were employed to identify factors associated with depression and in-hospital mortality (IHM), stratified by sex. Among 4,597,668 hospitalizations with T2DM, 202,094 (4.39%) included a depression diagnosis. Depression prevalence increased slightly over time (APC: 1.09% in women and 0.98% in men). Women consistently showed higher prevalence (OR 3.21; 95% CI: 3.18-3.24). Age, anxiety, obesity, alcohol and tobacco use, and personality disorders were significantly associated with the presence of a code for depression, with notable sex differences. Among patients with T2DM and depression, IHM was significantly associated with older age, more comorbidities, COVID-19 infection, hypoglycemia, dementia, and female gender, whereas obesity and anxiety had a protective effect. From 2017 to 2023, the prevalence of depression in hospitalized patients with T2DM in Spain increased slightly, particularly among older women, highlighting the need for integrated mental health screening and management during hospitalization.
越来越多的证据支持抑郁症与2型糖尿病（T2DM）之间的双向关系。抑郁症和T2DM的共存具有重大的临床意义。然而，很少有研究关注这两种疾病在T2DM住院患者中如何聚集在一起、相关因素以及它们对医院结局的影响。在本研究中，我们旨在评估2017年至2023年西班牙T2DM住院患者中抑郁症患病率的时间趋势。此外，我们分析了性别、年龄、焦虑、肥胖、酒精和烟草使用、痴呆、COVID-19感染以及人格障碍等变量在T2DM住院患者抑郁症存在情况下的关联，以及这些变量对住院死亡率（IHM）的影响。我们使用西班牙医院出院登记处（RAE-CMBD）进行了一项基于人群的队列研究。纳入年龄≥40岁且诊断为T2DM的成年人。通过使用ICD-10编码来识别抑郁症。使用连接点回归分析时间趋势。采用多变量逻辑回归模型来识别与抑郁症和住院死亡率（IHM）相关的因素，并按性别分层。在4597668例T2DM住院病例中，202094例（4.39%）包括抑郁症诊断。抑郁症患病率随时间略有增加（女性的年度百分比变化：1.09%，男性为0.98%）。女性的患病率一直较高（比值比3.21；95%置信区间：3.18 - 3.24）。年龄、焦虑、肥胖、酒精和烟草使用以及人格障碍与抑郁症编码的存在显著相关，存在明显的性别差异。在患有T2DM和抑郁症的患者中，IHM与年龄较大、合并症较多、COVID-19感染、低血糖、痴呆以及女性性别显著相关，而肥胖和焦虑具有保护作用。从2017年到2023年，西班牙T2DM住院患者中抑郁症的患病率略有增加，尤其是在老年女性中，这突出了住院期间进行综合心理健康筛查和管理的必要性。
