A systematic review and meta-analysis of the association between depression and insulin resistance.
A systematic review and meta-analysis of the association between depression and insulin resistance.
复制标题
DOI：
10.2337/dc12-1442
复制
发表时间：
2013-02
期刊：
影响因子：
16.2
通讯作者：
Ismail K
中科院分区：
文献类型：
--
作者：
Kan C;Silva N;Golden SH;Rajala U;Timonen M;Stahl D;Ismail K
抑郁症与2型糖尿病的发病有关。对观察性研究、对照试验和未发表的数据进行了系统回顾和荟萃分析，以检查抑郁症与胰岛素抵抗（IR）之间的关系。检索Medline、EMBASE和PsycInfo以查找截至2011年9月发表的研究。两名独立的评审员根据预先确定的纳入标准（研究设计和抑郁和IR的测量，排除糖尿病的流行病例）评估每份报告的合格性。对个体效应量进行标准化，并进行荟萃分析，使用随机效应计算汇总效应量。进行亚组分析和荟萃回归，以探索研究之间异质性的任何潜在来源。在审查的967篇摘要中，21项研究符合纳入标准，其中18项研究具有用于荟萃分析的适当数据（n = 25，847）。使用随机效应模型，合并效应量（95% CI）为0.19（0.11-0.27），具有显著异质性（I2 = 82.2%）。研究之间的异质性不能用年龄或性别来解释，但可以部分解释抑郁和IR评估的方法。尽管研究之间存在异质性，但在抑郁症和IR之间观察到了一个小但重要的横截面关联。这种关联的病理生理机制和方向需要进一步研究，使用有目的设计的前瞻性或干预性研究在糖尿病高危样本。
Depression is associated with the onset of type 2 diabetes. A systematic review and meta-analysis of observational studies, controlled trials, and unpublished data was conducted to examine the association between depression and insulin resistance (IR). Medline, EMBASE, and PsycINFO were searched for studies published up to September 2011. Two independent reviewers assessed the eligibility of each report based on predefined inclusion criteria (study design and measure of depression and IR, excluding prevalent cases of diabetes). Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size using random effects. Subgroup analyses and meta-regression were conducted to explore any potential source of heterogeneity between studies. Of 967 abstracts reviewed, 21 studies met the inclusion criteria of which 18 studies had appropriate data for the meta-analysis (n = 25,847). The pooled effect size (95% CI) was 0.19 (0.11–0.27) with marked heterogeneity (I2 = 82.2%) using the random-effects model. Heterogeneity between studies was not explained by age or sex, but could be partly explained by the methods of depression and IR assessments. A small but significant cross-sectional association was observed between depression and IR, despite heterogeneity between studies. The pathophysiology mechanisms and direction of this association need further study using a purposively designed prospective or intervention study in samples at high risk for diabetes.