Ding Wenlong, Shi Fachao, Fang Cunming, Fang Caoyang
Department of Cardiology, Xuancheng Hospital Affiliated to Wannan Medical College (Xuancheng People's Hospital), Xuancheng Anhui, 242000, China.
Department of Cardiology, Maanshan People's Hospital, Maanshan Hospital Affiliated to Wannan Medical College, Maanshan, 243000, Anhui, China.
Sci Rep. 2025 Jul 8;15(1):24581. doi: 10.1038/s41598-025-09258-7.
There is a known association between socioeconomic status (SES) and increased mortality risk in individuals with diabetes and its pre-diabetic state. Depression has been identified as a significant risk factor for mortality in populations with low SES. this study aims to gain a deeper Understanding of the relationship between SES and all-cause and cardiovascular mortality risk in individuals with diabetes and its pre-diabetic state by exploring the mediating role of depression. This study included 17,823 participants who participated in the National health and nutrition examination survey (NHANES) between 2005 and 2018. Weighted multivariate COX regression analysis was conducted to evaluate the association between SES and all-cause and cardiovascular mortality risk in individuals with diabetes and its pre-diabetic state. Additionally, mediation analysis was performed to explore the mediating role of depression. After adjusting for multiple variables, low SES was associated with a hazard ratio (HR) of 1.71 (95% CI: 1.42-2.02; P < 0.0001) for all-cause mortality risk and an HR of 1.88 (95% CI: 1.35-2.63; P < 0.001) for cardiovascular mortality risk in individuals with diabetes and its pre-diabetic state. Furthermore, after adjusting for multiple variables, depression was associated with an HR of 1.51 (95% CI: 1.28-1.79; P < 0.0001) for all-cause mortality risk and an HR of 1.64 (95% CI: 1.18-2.27; P = 0.003) for cardiovascular mortality risk. Mediation model results revealed that after complete adjustment, depression accounted for 10.34% of the mediating effect of the relationship between SES and all-cause mortality risk in individuals with diabetes and its pre-diabetic state, and 9.30% of the mediating effect of the relationship between SES and cardiovascular mortality risk. Identifying individuals with depression and providing appropriate treatment May lower the risk of all-cause and cardiovascular mortality associated with diabetes and its pre-diabetic state in the low SES population.
社会经济地位（SES）与糖尿病患者及其糖尿病前期状态个体的死亡风险增加之间存在已知关联。抑郁症已被确定为低社会经济地位人群死亡的重要风险因素。本研究旨在通过探讨抑郁症的中介作用，更深入地了解SES与糖尿病患者及其糖尿病前期状态个体的全因死亡率和心血管死亡率风险之间的关系。本研究纳入了2005年至2018年期间参加国家健康和营养检查调查（NHANES）的17823名参与者。进行加权多变量COX回归分析，以评估SES与糖尿病患者及其糖尿病前期状态个体的全因死亡率和心血管死亡率风险之间的关联。此外，进行中介分析以探讨抑郁症的中介作用。在对多个变量进行调整后，低SES与糖尿病患者及其糖尿病前期状态个体的全因死亡风险的风险比（HR）为1.71（95%CI：1.42-2.02；P<0.0001），心血管死亡风险的HR为1.88（95%CI：1.35-2.63；P<0.001）。此外，在对多个变量进行调整后，抑郁症与全因死亡风险的HR为1.51（95%CI：1.28-1.79；P<0.0001），心血管死亡风险的HR为1.64（95%CI：1.18-2.27；P=0.003）。中介模型结果显示，在完全调整后，抑郁症在SES与糖尿病患者及其糖尿病前期状态个体的全因死亡风险关系的中介效应中占10.34%，在SES与心血管死亡风险关系的中介效应中占9.30%。识别抑郁症患者并提供适当治疗可能会降低低社会经济地位人群中与糖尿病及其糖尿病前期状态相关的全因死亡率和心血管死亡率风险。
