Background: Depression may be associated with the risk of developing type 2 diabetes. The goal of this study was to explore the association of severe of depression with the risk of type 2 diabetes in adults in Guizhou, China.
Methods: A 10-year prospective cohort study of 7158 nondiabetes adults aged 18 years or older was conducted in Guizhou, southwest China from 2010 to 2020. The Patient Health Questionnaire-9 (PHQ-9) was used to measure the prevalence of depression. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) of depression and incident type 2 diabetes. A quantile regression (QR) analytical approach were applied to evaluate the associations of PHQ-9 score with plasma glucose values.
Results: A total of 739 type 2 diabetes cases were identified during a median follow-up of 6.59 years. The HR (95% CI) per 1-SD increase for baseline PHQ-9 score was 1.051 (1.021, 1.082) after multivariable adjustment. Compared with participants without depression, those with mild or more advanced depression had a higher risk of incident type 2 diabetes (HR:1.440 [95% CI, 1.095, 1.894]). Associations between depression with type 2 diabetes were suggested to be even stronger among women or participants aged ≥45 years (p < .05). There are significant positive associations of PHQ-9 score with 2-h oral glucose tolerance test blood glucose levels.
Conclusion: Depression significantly increased the risk of incident type 2 diabetes, especially in women, participants aged ≥45 years, Han ethnicity, and urban residents. These findings highlighted the importance and urgency of depression health care.
背景:抑郁症可能与2型糖尿病的发展风险有关。本研究旨在探索中国贵州省成年人中严重抑郁症与2型糖尿病风险的关系。 方法:在贵州省进行了一项为期10年的前瞻性队列研究, 共纳入了7,158名年龄在18岁及以上的非糖尿病患者。使用患者健康问卷-9(PHQ-9)测量抑郁症的患病率。采用Cox比例风险模型估计抑郁症和2型糖尿病发病的风险比值(HRs)和95%置信区间(95% CIs)。采用分位数回归(QR)分析方法评估PHQ-9得分与血浆葡萄糖值之间的关联。 结果:在中位随访6.59年期间, 共识别出739例2型糖尿病病例。经多变量调整后, 基线PHQ-9得分每增加1个标准差, HR(95% CI)为1.051(1.021, 1.082)。与无抑郁症状的参与者相比, 患有轻度或更严重的抑郁症的人患2型糖尿病的风险更高[HR(95% CI):1.440(1.095, 1.894)]。在女性或年龄≥45岁的参与者中, 抑郁症与2型糖尿病之间的关联更强(P<0.05)。PHQ-9得分与口服葡萄糖耐量试验(OGTT 2h)血糖水平之间存在显著正相关关系。 结论:抑郁症显著增加了2型糖尿病的发病风险, 尤其是在女性、年龄≥45岁、汉族和城市居民中。这些发现强调了抑郁症医疗保健的重要性和紧迫性。.
Keywords: 2型糖尿病; cohort study; depression; the Patient Health Questionnaire-9 (PHQ-9); type 2 diabetes; 患者健康问卷-9(PHQ-9); 抑郁症; 队列研究.
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.