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Nature子刊:Attention!抑郁症患者需警惕糖尿病

来源:生物谷 2016-04-18 07:42

                   

2016年4月18日讯 /生物谷BIOON/ --来自加拿大麦吉尔大学的研究人员最近发现同时患有抑郁症以及肥胖,高血压以及胆固醇异常等代谢疾病的病人发生2型糖尿病的风险更高。虽然之前研究指出抑郁与糖尿病之间存在某种联系,但是根据这项发表在国际学术期刊Molecular Psychiatry上的研究结果,当抑郁症与代谢风险因素结合在一起,2型糖尿病的患病风险会更高,甚至高于单个因素引起的风险总和。

文章作者Norbert Schmitz表示,越来越多的证据表明抑郁症与一些行为因素或者代谢风险因素结合在一起才会增加2型糖尿病和心血管疾病风险,单纯的抑郁症并不会造成这种结果,而这项研究的目的就在于评估存在抑郁症状,同时携带代谢风险因素的人发生2型糖尿病的风险如何。

这项为期四年半的研究将来自魁北克,年龄在40岁到69岁之间的2525名参与者分成四组:第一组中的参与者既存在抑郁症状又携带三种或更多种代谢风险因素;另外两组只存在抑郁或代谢疾病;参照组中的参与者不存在上述病症。

研究人员首先发现单纯的抑郁症并不会显著增加2型糖尿病风险,存在代谢疾病症状但不存在抑郁情况的参与者发生糖尿病的风险是参照组的大约四倍。而那些既存在抑郁又携带代谢风险因素的参与者发生糖尿病的风险是参照组的大约六倍,这些分析表明抑郁与代谢疾病症状结合会带来更大的糖尿病患病风险。

研究人员认为抑郁,代谢疾病症状与糖尿病风险之间存在多种作用方式。在某些情况下,抑郁与代谢风险因素之间可能出现恶性循环——一种情况会加剧另外一种情况的发生。有些抑郁症与身体代谢系统存在关联,因此可能导致体重增加,血压升高以及血糖代谢出现问题。与此同时,一些抗抑郁药物也会引起体重增加。

研究人员强调,并非所有的抑郁症都相同,抑郁症患者中只有一部分人会受到代谢疾病困扰。在治疗过程中应当将同时患有抑郁症和代谢疾病的病人分作一个亚组,将不同治疗方法进行整合打破两者之间的恶性循环。(生物谷Bioon.com)

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doi: 10.1038/mp.2016.7

Depression and risk of type 2 diabetes: the potential role of metabolic factors

N Schmitz1,2,3,4, S S Deschênes1,2, R J Burns1,2, K J Smith5, A Lesage6, I Strychar4,7, R Rabasa-Lhoret4,7,8, C Freitas2,3, E Graham2,3, P Awadalla9 and J L Wang

The aim of the present study was to evaluate the interaction between depressive symptoms and metabolic dysregulations as risk factors for type 2 diabetes. The sample comprised of 2525 adults who participated in a baseline and a follow-up assessment over a 4.5-year period in the Emotional Health and Wellbeing Study (EMHS) in Quebec, Canada. A two-way stratified sampling design was used, on the basis of the presence of depressive symptoms and metabolic dysregulation (obesity, elevated blood sugar, high blood pressure, high levels of triglycerides and decreased high-density lipoprotein). A total of 87 (3.5%) individuals developed diabetes. Participants with both depressive symptoms and metabolic dysregulation had the highest risk of diabetes (adjusted odds ratio=6.61, 95% confidence interval (CI): 4.86–9.01), compared with those without depressive symptoms and metabolic dysregulation (reference group). The risk of diabetes in individuals with depressive symptoms and without metabolic dysregulation did not differ from the reference group (adjusted odds ratio=1.28, 95% CI: 0.81–2.03), whereas the adjusted odds ratio for those with metabolic dysregulation and without depressive symptoms was 4.40 (95% CI: 3.42–5.67). The Synergy Index (SI=1.52; 95% CI: 1.07–2.17) suggested that the combined effect of depressive symptoms and metabolic dysregulation was greater than the sum of individual effects. An interaction between depression and metabolic dysregulation was also suggested by a structural equation model. Our study highlights the interaction between depressive symptoms and metabolic dysregulation as a risk factor for type 2 diabetes. Early identification, monitoring and a comprehensive management approach of both conditions might be an important diabetes prevention strategy.

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