Association between depressive symptoms and all-cause and cardiovascular mortality in diabetes patients: A national cohort study

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-07-17 DOI:10.1016/j.jad.2025.119957

Zheng Zhang , Huijie Xu , Yun Meng , Yangxinyu Yan , Yuanyuan Wang

{"title":"Association between depressive symptoms and all-cause and cardiovascular mortality in diabetes patients: A national cohort study","authors":"Zheng Zhang , Huijie Xu , Yun Meng , Yangxinyu Yan , Yuanyuan Wang","doi":"10.1016/j.jad.2025.119957","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Depression is a significant psychological burden frequently observed among diabetic patients, and it has been increasingly linked to higher mortality risks, particularly from cardiovascular diseases. Clarifying why depression contributes to these risks is essential for effective intervention strategies.</div></div><div><h3>Methods</h3><div>This national cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) (2005–2018), analyzing 4743 diabetic patients. Depressive symptoms were assessed using the PHQ-9 scale, and mortality data were linked through the National Death Index. The Systemic Immune-Inflammation Index (SII) was calculated to evaluate its mediating role in the relationship between depressive symptoms and mortality.</div></div><div><h3>Results</h3><div>Depressive symptoms significantly increased all-cause (HR = 1.32, 95 % CI = 1.07–1.63) and cardiovascular mortality (HR = 1.73, 95 % CI = 1.23–2.42) even after adjustments. SII mediated 8.0 % of the association with all-cause mortality and 6.0 % with cardiovascular mortality. Subgroup analyses revealed varied impacts based on demographic characteristics.</div></div><div><h3>Conclusion</h3><div>Depressive symptoms are linked to heightened mortality risks in diabetic patients, with SII serving as a critical mediating factor. Comprehensive management addressing both mental health and inflammation is essential for improving outcomes in this population.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119957"},"PeriodicalIF":4.9000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of affective disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165032725013990","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Depression is a significant psychological burden frequently observed among diabetic patients, and it has been increasingly linked to higher mortality risks, particularly from cardiovascular diseases. Clarifying why depression contributes to these risks is essential for effective intervention strategies.

Methods

This national cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) (2005–2018), analyzing 4743 diabetic patients. Depressive symptoms were assessed using the PHQ-9 scale, and mortality data were linked through the National Death Index. The Systemic Immune-Inflammation Index (SII) was calculated to evaluate its mediating role in the relationship between depressive symptoms and mortality.

Results

Depressive symptoms significantly increased all-cause (HR = 1.32, 95 % CI = 1.07–1.63) and cardiovascular mortality (HR = 1.73, 95 % CI = 1.23–2.42) even after adjustments. SII mediated 8.0 % of the association with all-cause mortality and 6.0 % with cardiovascular mortality. Subgroup analyses revealed varied impacts based on demographic characteristics.

Conclusion

Depressive symptoms are linked to heightened mortality risks in diabetic patients, with SII serving as a critical mediating factor. Comprehensive management addressing both mental health and inflammation is essential for improving outcomes in this population.

查看原文本刊更多论文

糖尿病患者抑郁症状与全因死亡率和心血管死亡率之间的关系：一项国家队列研究

背景：抑郁症是糖尿病患者经常观察到的一种重要的心理负担，它与更高的死亡风险，特别是心血管疾病的死亡风险越来越相关。阐明抑郁症为何会导致这些风险，对于有效的干预策略至关重要。方法：本国家队列研究利用国家健康与营养调查（NHANES）（2005-2018）的数据，分析了4743名糖尿病患者。使用PHQ-9量表评估抑郁症状，并通过国家死亡指数将死亡率数据联系起来。计算全身免疫炎症指数（SII）来评估其在抑郁症状和死亡率之间的中介作用。结果:抑郁症状显著增加全因(HR = 1.32,95 CI  % = 1.07 - -1.63)和心血管死亡率(HR = 1.73,95 CI  % = 1.23 - -2.42)即使调整。SII介导的全因死亡率为8.0 %，心血管死亡率为6.0 %。亚组分析揭示了基于人口统计学特征的不同影响。结论：抑郁症状与糖尿病患者死亡风险增加有关，SII是一个关键的中介因素。针对心理健康和炎症的综合管理对于改善这一人群的预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.