背景:抗抑郁药的使用在青少年和年轻人中呈上升趋势,人群患2型糖尿病的风险也越来越高。然而,在这些年龄组中,抗抑郁药的使用与糖尿病发病率之间的关系仍然知之甚少.
方法:遵守PRISMA指南和Cochrane手册,我们在PubMed进行了全面的搜索,Scopus,Embase,和WebofScience至2024年2月21日,在PROSPERO上注册我们的协议(CRD42024516272)。
结果:六项研究,来自北美的16,470至1,582,914名参与者,涵盖2010年至2023年,欧洲,亚洲,包括在内。荟萃分析显示,抗抑郁药的使用与糖尿病发病之间存在显着关联。每1,000个观察中有10个病例(p<0.01;I2=100%)。与不使用抗抑郁药或使用低剂量抗抑郁药的青少年相比,使用高剂量抗抑郁药的青少年患糖尿病的风险增加了62%(风险比=1.67;95%CI1.19-2.35;I2=87%;p<0.01)。研究的总体质量很高,纽卡斯尔-渥太华量表的平均得分为7.66。敏感性分析强调了这些发现的稳健性,除非删除特定研究,表明异质性的潜在来源。
结论:青少年使用抗抑郁药与糖尿病发病风险显著增加有关,特别是在更高的剂量。这一发现强调了对该人群的血糖水平进行警惕监测的必要性,并需要对潜在机制和长期结果进行进一步调查。
BACKGROUND: The use of
antidepressants has been on the rise among adolescents and young adults, populations also increasingly at risk for type 2 diabetes. However, the relationship between antidepressant uses and diabetes incidence in these age groups remains poorly understood.
METHODS: Adhering to PRISMA guidelines and the Cochrane Handbook, we conducted a comprehensive search in PubMed, Scopus, Embase, and Web of Science up to 21 February 2024, registering our protocol on PROSPERO (CRD42024516272).
RESULTS: Six studies, ranging from 16, 470 to 1, 582, 914 participants and spanning 2010 to 2023 across North America, Europe, and Asia, were included. The meta-analysis revealed a significant association between antidepressant use and diabetes onset, with 10 cases per 1, 000 observations (p < 0.01; I2 = 100%). Adolescents using high doses of
antidepressants showed a 62% increased risk of developing diabetes compared to non-users or those on low doses (Risk ratio = 1.67; 95% CI 1.19-2.35; I2 = 87%; p < 0.01). The overall quality of the studies was high, with an average Newcastle-Ottawa Scale score of 7.66. Sensitivity analysis highlighted the robustness of these findings, except when removing specific studies, indicating potential sources of heterogeneity.
CONCLUSIONS: Antidepressant use in adolescents is associated with a significantly increased risk of diabetes onset, particularly at higher doses. This finding underscores the necessity for vigilant monitoring of glucose levels in this population and warrants further investigation into the underlying mechanisms and long-term outcomes.