Depression, Diabetes and Osteoporosis: A Cohort Analysis

描述（由申请人提供）：研究表明，精神障碍与严重的医学疾病共同发生的频率比预期的更高。本申请的目的是探索抑郁症（重度抑郁症和抑郁综合征）与2型糖尿病（及其并发症）和骨质疏松症共病代谢失调之间的前瞻性关系，并评估这些关系的潜在介质。分析的三个目的是（1）使用生存分析来检查抑郁症对结局发生率的影响，（2）创建代谢失调的潜变量模型，并评估其作为抑郁症与糖尿病和骨质疏松症之间关系的中介的效用，以及（3）调查协变量对这些关系的调节作用，包括酪氨酸羟化酶基因的多态性。非洲经委会研究最近完成了23年的后续行动，为探讨这些问题提供了一个独特的机会。抑郁症本身与严重的功能障碍有关，因此，确定将其与后来使人衰弱的医学疾病联系起来的机制至关重要，以便确定干预目标，以减少受影响个体的后续负担。

DESCRIPTION (provided by applicant): Research has shown that mental disorders co-occur with serious medical illnesses more often than expected by chance alone. The goal of this application is to explore the prospective relationship between depression (both Major Depressive Disorder and depression syndrome) and comorbid metabolic dysregulation as measured by Type 2 Diabetes (and its complications) and Osteoporosis, and to evaluate potential mediators of these relationships. The three aims of the analysis are to (1) use survival analysis to examine the effect of depression on the incidence of the outcomes, (2) create a latent variable model of metabolic dysregulation and evaluate its utility as a mediator of the relationships between depression and Diabetes and Osteoporosis, and (3) investigate the moderating effects of covariates on these relationships, including polymorphisms of the tyrosine hydroxylase gene. The ECA Study recently completed its 23-year follow-up and provides a unique opportunity for exploring these questions. Depression is associated with significant functional impairment in and of itself, and thus it is crucial to identify mechanisms linking it to later debilitating medical illnesses in order to identify targets for intervention to reduce subsequent burdens on affected individuals.