Depression predicts all-cause mortality: epidemiological evaluation from the ACCORD HRQL substudy.
Depression predicts all-cause mortality: epidemiological evaluation from the ACCORD HRQL substudy.
复制标题
DOI：
10.2337/dc11-1791
复制
发表时间：
2012-08
期刊：
影响因子：
16.2
通讯作者：
Katon WJ
中科院分区：
文献类型：
--
作者：
Sullivan MD;O'Connor P;Feeney P;Hire D;Simmons DL;Raisch DW;Fine LJ;Narayan KM;Ali MK;Katon WJ
抑郁症影响高达20-25%的2型糖尿病成年人，并可能增加全因死亡率，但很少有设计良好的研究检查抑郁症对2型糖尿病心血管疾病结局的影响。雅阁（控制糖尿病心血管风险的行动）健康相关生活质量子研究中共有2，053名参与者完成了患者健康问卷（PHQ）-9基线和12个月，36个月和48个月的抑郁症状测量。使用考克斯比例风险回归模型估计抑郁症对方案定义的临床结局的时变影响的风险比（HR）（95% CI），调整和不调整人口统计学、试验相关、临床和行为变量。在完全校正的模型中，抑郁与雅阁主要复合结局无显著相关性（心血管死亡、非致命性心脏病发作或中风）（HR 1.53 [95% CI 0.85-2.73]）或雅阁微血管复合结局（0.93 [0.53-1.62]），但在PHQ评估的可能的重度抑郁症患者中，（2.24 [1.24-4.06]）和PHQ评分≥10（1.84 [1.17-2.89]）。抑郁症对全因死亡率的影响与既往心血管事件无关，也与分配到强化或标准控制组无关。可能的重度抑郁（PHQ-9）对雅阁大血管终点有临界影响（1.42 [0.99-2.04]）。抑郁症增加了全因死亡的风险，并可能增加心血管事件高风险的2型糖尿病成人发生大血管事件的风险。
Depression affects up to 20–25% of adults with type 2 diabetes and may increase all-cause mortality, but few well-designed studies have examined the effects of depression on the full range of cardiovascular disease outcomes in type 2 diabetes. A total of 2,053 participants in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Health-Related Quality of Life substudy completed the Patient Health Questionnaire (PHQ)-9 measure of depression symptoms at baseline and 12, 36, and 48 months. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) (95% CI) for the time-varying impact of depression on protocol-defined clinical outcomes with and without adjustment for demographic, trial-related, clinical, and behavioral variables. In fully adjusted models, depression was not significantly related to the ACCORD primary composite outcome (cardiovascular death, nonfatal heart attack, or stroke) (HR 1.53 [95% CI 0.85–2.73]) or to the ACCORD microvascular composite outcome (0.93 [0.53–1.62]), but all-cause mortality was significantly increased both in those with PHQ-assessed probable major depression (2.24 [1.24–4.06]) and PHQ score of ≥10 (1.84 [1.17–2.89]). The effect of depression on all-cause mortality was not related to previous cardiovascular events or to assignment to intensive or standard glycemia control. Probable major depression (by PHQ-9) had a borderline impact on the ACCORD macrovascular end point (1.42 [0.99–2.04]). Depression increases the risk of all-cause mortality and may increase the risk of macrovascular events among adults with type 2 diabetes at high risk for cardiovascular events.
登录
查看更多内容
影响因子：
--
作者：
Pan, An;Lucas, Michel;Sun, Qi;van Dam, Rob M.;Franco, Oscar H.;Willett, Walter C.;Manson, JoAnn E.;Rexrode, Kathryn M.;Ascherio, Alberto;Hu, Frank B.
通讯作者：
Hu, Frank B.
影响因子：
7
作者：
KATON, W;SCHULBERG, H
通讯作者：
SCHULBERG, H
影响因子：
16.2
作者：
Katon, WJ;Rutter, C;Von Korff, M
通讯作者：
Von Korff, M
影响因子：
16.2
作者：
Egede, LE;Nietert, PJ;Zheng, D
通讯作者：
Zheng, D
影响因子：
--
作者：
SCHLEIFER, SJ;MACARIHINSON, MM;ZUCKER, HD
通讯作者：
ZUCKER, HD