成人降糖治疗后 HbA1c 降低与抑郁症状变化之间的关系:干预研究的系统回顾。

IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM
Andreas Schmitt, Magdalena Beran, Anouk Geraets, Marjolein M Iversen, Giesje Nefs, Arie Nouwen, Frans Pouwer, Jörg W Huber, Miranda T Schram
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引用次数: 0

摘要

导言高血糖可能是糖尿病与抑郁症状之间的联系途径;降低血糖水平可能有助于减轻糖尿病合并抑郁症状。由于随机对照试验有助于了解时间上的关联,我们系统地回顾了有关降低血红蛋白 HbA1c 的干预措施与抑郁症状之间潜在关联的证据:我们在 PubMed、PsycINFO、CINAHL 和 EMBASE 数据库中检索了 2000 年 1 月至 2009 年 2020 年期间发表的评估 HbA1c 降低干预措施并包括抑郁症状评估的随机对照试验。研究质量采用 Cochrane 偏倚风险工具进行评估。PROSPERO 注册:CRD42020215541.Results:我们检索了 1642 项研究,其中 12 项符合纳入标准。九项研究的偏倚风险较高,三项研究的偏倚风险不明确。五项研究的基线抑郁症状评分显示抑郁症状升高。基线 HbA1c 为结论:我们发现现有数据不足以估计降糖治疗后 HbA1c 降低与抑郁症状变化之间的关联。我们的发现指出了糖尿病治疗文献中的一个重要空白。未来对改善血糖结果的干预措施进行测试的临床试验可能会考虑将抑郁症状作为一项结果进行测量,以便对这种关联进行分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Associations between HbA1c Reduction and Change in Depressive Symptoms following Glucose-lowering Treatment in Adults: A Systematic Review of Intervention Studies.

Introduction: Hyperglycemia constitutes a likely pathway linking diabetes and depressive symptoms; lowering glycemic levels may help reduce diabetes-comorbid depressive symptoms. Since randomized controlled trials can help understand temporal associations, we systematically reviewed the evidence regarding the potential association of hemoglobin HbA1c lowering interventions with depressive symptoms.

Methods: PubMed, PsycINFO, CINAHL, and EMBASE databases were searched for randomized controlled trials evaluating HbA1c-lowering interventions and including assessment of depressive symptoms published between 01/2000-09/2020. Study quality was evaluated using the Cochrane Risk of Bias tool. PROSPERO registration: CRD42020215541.

Results: We retrieved 1,642 studies of which twelve met our inclusion criteria. Nine studies had high and three unclear risks of bias. Baseline depressive symptom scores suggest elevated depressive symptoms in five studies. Baseline HbA1c was <8.0% (<64 mmol/mol) in two, 8.0-9.0% (64-75 mmol/mol) in eight, and ≥10.0% (≥86 mmol/mol) in two studies. Five studies found greater HbA1c reduction in the treatment group; three of these found greater depressive symptom reduction in the treatment group. Of four studies analyzing whether the change in HbA1c was associated with the change in depressive symptoms, none found a significant association. The main limitation of these studies was relatively low levels of depressive symptoms at baseline, limiting the ability to show a lowering in depressive symptoms after HbA1c reduction.

Conclusions: We found insufficient available data to estimate the association between HbA1c reduction and depressive symptom change following glucose-lowering treatment. Our findings point to an important gap in the diabetes treatment literature. Future clinical trials testing interventions to improve glycemic outcomes might consider measuring depressive symptoms as an outcome to enable analyses of this association.

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来源期刊
Current diabetes reviews
Current diabetes reviews ENDOCRINOLOGY & METABOLISM-
CiteScore
6.30
自引率
0.00%
发文量
158
期刊介绍: Current Diabetes Reviews publishes frontier reviews on all the latest advances on diabetes and its related areas e.g. pharmacology, pathogenesis, complications, epidemiology, clinical care, and therapy. The journal"s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians who are involved in the field of diabetes.
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