我们旨在研究纵向队列研究中糖尿病与抑郁风险之间的关系,以及如果糖尿病减少,人群中抑郁的发生率将降低多少。Medline/PubMed,EMBASE,PsycINFO,和CochraneLibrary数据库在1990年1月至2017年12月期间检索英语发表的文献.评估了具有抑郁标准的纵向研究和自我报告医生的糖尿病诊断或诊断性血液测试测量。系统评价和荟萃分析综合了结果。学习质量,异质性,和发表偏倚进行了检查。使用随机效应模型计算汇总赔率比。人口归因分数(PAF)用于估计潜在的预防影响。20篇高质量文章符合纳入标准并进行分析。糖尿病和抑郁症之间的合并比值比(OR)为1.33(95%CI,1.18-1.51)。对于各种研究类型,OR如下:前瞻性研究(OR1.34,95%CI1.14-1.57);回顾性研究(OR1.30,95%CI1.05-1.62);自我报告的糖尿病诊断(OR1.37,95%CI1.17-1.60);和诊断性糖尿病血液检查(OR1.25,95%CI1.04-1.52)。PAFs表明,全球超过950万抑郁症病例可能归因于糖尿病。糖尿病减少10-25%可能会在全球范围内预防93万至234万例抑郁症病例。我们的系统评价提供了相当有力的证据来支持糖尿病是抑郁的独立危险因素的假设,同时也承认减少危险因素的影响。研究设计和暴露的诊断测量可能为预防性干预提供信息。
We aim to examine the relationship between diabetes and depression risk in longitudinal cohort studies and by how much the incidence of depression in a population would be reduced if diabetes was reduced. Medline/PubMed, EMBASE, PsycINFO, and Cochrane Library databases were searched for English-language published literature from January 1990 to December 2017. Longitudinal studies with criteria for depression and self-report doctors\' diagnoses or diagnostic blood test measurement of diabetes were assessed. Systematic
review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Pooled odds ratios were calculated using random effects models. Population attributable fractions (PAFs) were used to estimate potential preventive impact. Twenty high-quality articles met inclusion criteria and were analyzed. The pooled odds ratio (OR) between diabetes and depression was 1.33 (95% CI, 1.18-1.51). For the various study types the ORs were as follows: prospective studies (OR 1.34, 95% CI 1.14-1.57); retrospective studies (OR 1.30, 95% CI 1.05-1.62); self-reported diagnosis of diabetes (OR 1.37, 95% CI 1.17-1.60); and diagnostic diabetes blood test (OR 1.25, 95% CI 1.04-1.52). PAFs suggest that over 9.5 million of global depression cases are potentially attributable to diabetes. A 10-25% reduction in diabetes could potentially prevent 930,000 to 2.34 million depression cases worldwide. Our systematic
review provides fairly robust evidence to support the hypothesis that diabetes is an independent risk factor for depression while also acknowledging the impact of risk factor reduction, study design and diagnostic measurement of exposure which may inform preventive interventions.