{"title":"患有不同糖尿病的美国成年人的抑郁症状及其与全因死亡率和心血管死亡率的关系。","authors":"Hua-Zhao Xu, Xiang-Da Meng, Qian Liu, Yu-Jun Xiong","doi":"10.1177/00912174241303099","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveThe relationship between diabetes, depressive symptoms, and mortality is well established. However, the effect of depressive symptoms on mortality among people with prediabetes remains unclear. This study examined the effects of depressive symptoms on mortality across different diabetic statuses.MethodsData were analyzed from cross-sectional samples collected as part of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, with a final sample size of 36,246 participants. Mortality status and cause of death were prospectively determined by cross-referencing records with the publicly accessible National Death Index through 2019. Kaplan-Meier survival curves and Cox regression analysis were utilized to assess the relationship between depressive symptoms and mortality across different diabetic statuses from nondiabetic to prediabetic to diabetic.ResultsIn the non-diabetic group, no effect of depression severity on all-cause mortality or cardiovascular mortality was found in the final models. In the prediabetic group, however, the hazard ratios were increased for both mild depressive symptoms (HR = 1.35, 95% CI = 1.14-1.60) and moderate-to-severe depressive symptoms (HR = 1.65, 95% CI = 1.31-2.08). In the diabetic group, surprisingly, the all-cause mortality risk was somewhat lower than in the pre-diabetic group (HR = 1.28, 95% CI = 1.08-1.51 for mild and HR = 1.29, 95% CI = 1.06-1.56 for moderate-to-severe depressive symptoms). Similar patterns were noted for cardiovascular mortality, where risk of moderate-severe depressive symptoms was even greater in the prediabetic group (HR = 1.83, 95% CI = 1.18-2.85) than in the diabetic group.ConclusionIn this prospective cohort study of a nationally representative sample of U.S. adults, a positive association was found between depressive symptoms and mortality across different diabetic statuses. These findings highlight the importance of evaluating depressive symptoms across the glycemic spectrum, especially among individuals with prediabetes.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"468-488"},"PeriodicalIF":1.3000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Depressive symptoms, all-cause mortality, and cardiovascular-specific mortality among adults with different diabetic status in the United States.\",\"authors\":\"Hua-Zhao Xu, Xiang-Da Meng, Qian Liu, Yu-Jun Xiong\",\"doi\":\"10.1177/00912174241303099\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>ObjectiveThe relationship between diabetes, depressive symptoms, and mortality is well established. However, the effect of depressive symptoms on mortality among people with prediabetes remains unclear. This study examined the effects of depressive symptoms on mortality across different diabetic statuses.MethodsData were analyzed from cross-sectional samples collected as part of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, with a final sample size of 36,246 participants. Mortality status and cause of death were prospectively determined by cross-referencing records with the publicly accessible National Death Index through 2019. Kaplan-Meier survival curves and Cox regression analysis were utilized to assess the relationship between depressive symptoms and mortality across different diabetic statuses from nondiabetic to prediabetic to diabetic.ResultsIn the non-diabetic group, no effect of depression severity on all-cause mortality or cardiovascular mortality was found in the final models. In the prediabetic group, however, the hazard ratios were increased for both mild depressive symptoms (HR = 1.35, 95% CI = 1.14-1.60) and moderate-to-severe depressive symptoms (HR = 1.65, 95% CI = 1.31-2.08). In the diabetic group, surprisingly, the all-cause mortality risk was somewhat lower than in the pre-diabetic group (HR = 1.28, 95% CI = 1.08-1.51 for mild and HR = 1.29, 95% CI = 1.06-1.56 for moderate-to-severe depressive symptoms). Similar patterns were noted for cardiovascular mortality, where risk of moderate-severe depressive symptoms was even greater in the prediabetic group (HR = 1.83, 95% CI = 1.18-2.85) than in the diabetic group.ConclusionIn this prospective cohort study of a nationally representative sample of U.S. adults, a positive association was found between depressive symptoms and mortality across different diabetic statuses. These findings highlight the importance of evaluating depressive symptoms across the glycemic spectrum, especially among individuals with prediabetes.</p>\",\"PeriodicalId\":50294,\"journal\":{\"name\":\"International Journal of Psychiatry in Medicine\",\"volume\":\" \",\"pages\":\"468-488\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Psychiatry in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00912174241303099\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Psychiatry in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00912174241303099","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/22 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
目的:糖尿病、抑郁症状和死亡率之间的关系已得到公认。然而,抑郁症状对糖尿病前期的影响及其与死亡率的关系仍不清楚。本研究旨在调查不同糖尿病状态下抑郁症状对死亡率的影响:研究分析了 1999 年至 2018 年美国国家健康与营养调查(NHANES)的数据,最终样本量为 36246 人。通过与公开访问的国家死亡指数(National Death Index)进行交叉比对,确定了截至 2019 年的死亡状态和死因。利用卡普兰-梅耶生存曲线和考克斯回归分析评估了从非糖尿病、糖尿病前期到糖尿病等不同糖尿病状态下抑郁症状与死亡率之间的关系:结果:在非糖尿病组,抑郁严重程度对全因死亡率或心血管死亡率的影响在最终模型中未发现。然而,在糖尿病前期组,轻度抑郁症状(HR = 1.349,95% CI = 1.138-1.600)和中重度抑郁症状(HR = 1.651,95% CI = 1.309-2.082)的危险比均有所增加。令人惊讶的是,糖尿病组的风险略低于糖尿病前期组(轻度抑郁症状的 HR = 1.279,95% CI = 1.084-1.509;中重度抑郁症状的 HR = 1.285,95% CI = 1.056-1.563)。心血管疾病(CVD)死亡率也有类似的风险模式,在糖尿病前期组中,中重度症状的风险更大(HR = 1.834,95% CI = 1.180-2.851):在这项对具有全国代表性的美国成年人样本进行的前瞻性队列研究中,发现抑郁症状与不同糖尿病状态下的死亡率之间存在正相关。这些研究结果突显了在不同血糖范围内评估抑郁症状的重要性,尤其是在糖尿病前期患者中。
Depressive symptoms, all-cause mortality, and cardiovascular-specific mortality among adults with different diabetic status in the United States.
ObjectiveThe relationship between diabetes, depressive symptoms, and mortality is well established. However, the effect of depressive symptoms on mortality among people with prediabetes remains unclear. This study examined the effects of depressive symptoms on mortality across different diabetic statuses.MethodsData were analyzed from cross-sectional samples collected as part of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, with a final sample size of 36,246 participants. Mortality status and cause of death were prospectively determined by cross-referencing records with the publicly accessible National Death Index through 2019. Kaplan-Meier survival curves and Cox regression analysis were utilized to assess the relationship between depressive symptoms and mortality across different diabetic statuses from nondiabetic to prediabetic to diabetic.ResultsIn the non-diabetic group, no effect of depression severity on all-cause mortality or cardiovascular mortality was found in the final models. In the prediabetic group, however, the hazard ratios were increased for both mild depressive symptoms (HR = 1.35, 95% CI = 1.14-1.60) and moderate-to-severe depressive symptoms (HR = 1.65, 95% CI = 1.31-2.08). In the diabetic group, surprisingly, the all-cause mortality risk was somewhat lower than in the pre-diabetic group (HR = 1.28, 95% CI = 1.08-1.51 for mild and HR = 1.29, 95% CI = 1.06-1.56 for moderate-to-severe depressive symptoms). Similar patterns were noted for cardiovascular mortality, where risk of moderate-severe depressive symptoms was even greater in the prediabetic group (HR = 1.83, 95% CI = 1.18-2.85) than in the diabetic group.ConclusionIn this prospective cohort study of a nationally representative sample of U.S. adults, a positive association was found between depressive symptoms and mortality across different diabetic statuses. These findings highlight the importance of evaluating depressive symptoms across the glycemic spectrum, especially among individuals with prediabetes.
期刊介绍:
The International Journal of Psychiatry in Medicine (IJPM) bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious, and cultural factors in the development and treatment of illness; the relationship of biomarkers to psychiatric symptoms and syndromes in primary care...