对近 800 万德国门诊患者进行的为期八年的 2 型糖尿病与抑郁症双向关联的全国性研究

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM BMJ Open Diabetes Research & Care Pub Date : 2024-05-01 DOI:10.1136/bmjdrc-2023-003903
Woo Ri Chae, Claudia Kohring, Christopher Rohde, Ole Köhler-Forsberg, Christian Otte, Jakob Holstiege
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The bidirectional risk was evaluated over an 8-year period using mixed-effects Cox proportional hazards models, adjusting for the Charlson Comorbidity Index, urbanicity, and area-level deprivation. Results New type 2 diabetes diagnosis was associated with higher depression risk over 8 years (N=54 561 with depression, HR=1.23, 99% CI=1.21 to 1.24). Similarly, depression diagnosis was linked to an increased type 2 diabetes risk (N=71 848 with type 2 diabetes, HR=1.15, 99% CI=1.14 to 1.17). The association between depression and type 2 diabetes was stronger in younger age groups, especially under 34 years. Findings held across sex-stratified analyses. Time stratification showed a more pronounced association between type 2 diabetes and depression risk during the earlier follow-up quarters, whereas the risk of developing type 2 diabetes after depression diagnosis remained constant throughout the follow-up period. 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引用次数: 0

摘要

导言:有关 2 型糖尿病和抑郁症的研究大多依赖于医院诊断或处方数据,忽略了许多门诊诊断。我们的目的是量化新诊断出的 2 型糖尿病患者患抑郁症的风险,以及新诊断出的 2 型糖尿病患者患抑郁症的风险,同时探讨不同年龄、性别和随访时间的潜在风险差异。研究设计和方法 我们利用 2012 年至 2022 年德国全国范围内的门诊索赔数据进行了一项匹配队列研究。参与者为 2015 年新诊断出的 2 型糖尿病患者(N=294 642)或抑郁症患者(N=1 271 537),与未患有这些疾病的对照组按年龄、性别和地区以 1:4 的比例进行匹配。采用混合效应 Cox 比例危险模型对 8 年间的双向风险进行了评估,并对夏尔森合并症指数、城市化程度和地区贫困程度进行了调整。结果 8年间,新诊断出的2型糖尿病与较高的抑郁风险相关(54 561人患有抑郁症,HR=1.23,99% CI=1.21至1.24)。同样,抑郁症诊断与 2 型糖尿病风险增加有关(2 型糖尿病患者人数=71 848,HR=1.15,99% CI=1.14-1.17)。抑郁症与 2 型糖尿病之间的关联在年轻群体中更为明显,尤其是 34 岁以下的人群。性别分层分析结果也是如此。时间分层显示,在较早的随访季度中,2 型糖尿病与抑郁症风险之间的关联更为明显,而抑郁症确诊后罹患 2 型糖尿病的风险在整个随访期间保持不变。结论 我们的研究结果证实了 2 型糖尿病与抑郁症之间的双向联系,尤其是在年轻人中。由于 2 型糖尿病和抑郁症的发病率很高,未来的研究需要探讨预防性方法能否降低这种合并症的发病风险。没有数据。由于《德国社会法典》(Fünftes Sozialgesetzbuch, SGB V)的数据保护规定,本研究分析的数据不对外公开。
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Eight-year nationwide study of the bidirectional association between type 2 diabetes and depression in nearly 8 million German outpatients
Introduction Research linking type 2 diabetes and depression mostly relied on hospital-based diagnoses or prescription data, overlooking many outpatient diagnoses. We aimed to quantify the risks of depression in individuals newly diagnosed with type 2 diabetes, and type 2 diabetes in those newly diagnosed with depression, while exploring potential risk differences depending on age, sex, and follow-up time. Research design and methods We conducted a matched cohort study using German nationwide outpatient claims data from 2012 to 2022. Participants were individuals newly diagnosed with type 2 diabetes (N=294 642) or depression (N=1 271 537) in 2015, matched in a 1:4 ratio to controls without these conditions by age, sex, and region. The bidirectional risk was evaluated over an 8-year period using mixed-effects Cox proportional hazards models, adjusting for the Charlson Comorbidity Index, urbanicity, and area-level deprivation. Results New type 2 diabetes diagnosis was associated with higher depression risk over 8 years (N=54 561 with depression, HR=1.23, 99% CI=1.21 to 1.24). Similarly, depression diagnosis was linked to an increased type 2 diabetes risk (N=71 848 with type 2 diabetes, HR=1.15, 99% CI=1.14 to 1.17). The association between depression and type 2 diabetes was stronger in younger age groups, especially under 34 years. Findings held across sex-stratified analyses. Time stratification showed a more pronounced association between type 2 diabetes and depression risk during the earlier follow-up quarters, whereas the risk of developing type 2 diabetes after depression diagnosis remained constant throughout the follow-up period. Conclusions Our findings confirm a bidirectional link between type 2 diabetes and depression, particularly in younger individuals. As type 2 diabetes and depression are frequent, future research needs to study whether preventive approaches can reduce the risk of developing this comorbidity. No data are available. The data analyzed in this study are not publicly available due to the data protection regulations of the German Social Code Book (Fünftes Sozialgesetzbuch, SGB V).
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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
期刊最新文献
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