Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis
Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis
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DOI：
10.1007/s00125-006-0159-x
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发表时间：
2006-05-01
期刊：
影响因子：
8.2
通讯作者：
Pouwer, F
中科院分区：
文献类型：
--
作者：
Knol, MJ;Twisk, JWR;Pouwer, F
证据强烈表明抑郁症和2型糖尿病是相关的，但这种关联的方向尚不清楚。抑郁症可能是糖尿病的结果，但也可能是2型糖尿病发病的一个危险因素。本研究通过回顾文献和对这一主题的纵向研究进行荟萃分析来检验后一种关联。Medline和PsycInfo检索了2005年1月之前发表的文章。所有研究抑郁症和2型糖尿病发病之间关系的研究都被纳入其中。采用固定效应和随机效应模型计算综合相对风险。为了探索研究间异质性的来源，我们进行了亚组分析和meta回归分析。9项研究符合本荟萃分析的纳入标准。固定效应模型的合并相对危险度为1.26(1.13 ~ 1.39)，随机效应模型的合并相对危险度为1.37（1.14 ~ 1.63）。研究间的异质性不能由以下因素解释：(1)研究是否在基线时控制未发现的糖尿病；(2)糖尿病随访评估方法；(3)研究人群患糖尿病的基线总体风险；(4)随访时间。抑郁的成年人患2型糖尿病的风险增加37%。这种关系背后的病理生理机制尚不清楚，需要进一步研究。需要一项随机对照研究来测试有效预防或治疗抑郁症是否能减少2型糖尿病的发病率及其对健康的影响。
Evidence strongly suggests that depression and type 2 diabetes are associated, but the direction of the association is still unclear. Depression may occur as a consequence of having diabetes, but may also be a risk factor for the onset of type 2 diabetes. This study examined the latter association by reviewing the literature and conducting a meta-analysis of longitudinal studies on this topic.Medline and PsycInfo were searched for articles published up to January 2005. All studies that examined the relationship between depression and the onset of type 2 diabetes were included. Pooled relative risks were calculated using fixed and random effects models. To explore sources of heterogeneity between studies, subgroup analyses and meta-regression analyses were performed.Nine studies met our inclusion criteria for this meta-analysis. The pooled relative risk was 1.26 (1.13-1.39) using the fixed effects model and 1.37 (1.14-1.63) using the random effects model. Heterogeneity between studies could not be explained by (1) whether studies controlled for undetected diabetes at baseline; (2) the method of diabetes assessment at follow-up; (3) the baseline overall risk of diabetes in the study population; and (4) follow-up duration.Depressed adults have a 37% increased risk of developing type 2 diabetes mellitus. The pathophysiological mechanisms underlying this relationship are still unclear and warrant further research. A randomised controlled study is needed to test whether effective prevention or treatment of depression can reduce the incidence of type 2 diabetes and its health consequences.