JCEM:抑郁症合并糖尿病患者抗抑郁药使用与晚期糖尿病结局之间的关联

2021-07-19 MedSci原创 MedSci原创

与依从性差相比,定期使用抗抑郁药与较低的晚期糖尿病并发症风险相关。临床医生应强调抑郁症和糖尿病患者的抗抑郁治疗依从性。

糖尿病患者合并抑郁症会使患者结局恶化。抗抑郁药可能会减轻抑郁症的不利影响;然而,它们与心脏代谢不良反应相关。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在探究抗抑郁治疗与抑郁症和糖尿病患者晚期糖尿病并发症和死亡率之间的关系。

研究人员使用台湾全民健康保险数据库确定了36276名抑郁症和新治疗的抑郁症患者进行了一项全国性的回顾性队列研究。6个月窗口内的抗抑郁药治疗模式分为无、依从性较差、部分使用和常规使用,研究人员在Cox比例风险回归分析中考虑了时间相关变量,并调整了时间相关的合并症以及同时使用的药物。研究人员比较了不同类别的抗抑郁药。大血管和微血管并发症以及全因死亡率是该研究的主要结局。研究人员选择苯二氮卓类药物作为阴性对照暴露。

Cox模型估计的晚期糖尿病结局风险比

与抗抑郁药依从性较差相比,经常使用抗抑郁药与大血管并发症风险降低0.92倍和全因死亡风险降低0.86倍相关,但与微血管并发症无关。常规使用选择性5-羟色胺再摄取抑制剂可使大血管并发症和全因死亡率的风险分别降低0.83倍和0.75倍。定期使用三环或四环抗抑郁药可使全因死亡风险降低0.78倍。定期使用苯二氮卓类药物与糖尿病结局无关。

由此可见,与依从性差相比,定期使用抗抑郁药与较低的晚期糖尿病并发症风险相关。临床医生应强调抑郁症和糖尿病患者的抗抑郁治疗依从性。

原始出处:

Chi-Shin Wu.et al.Associations Between Antidepressant Use and Advanced Diabetes Outcomes in Patients with Depression and Diabetes Mellitus.JCEM.2021.https://doi.org/10.1210/clinem/dgab443

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    2022-05-04 achengzhao
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    2021-10-30 wetgdt
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    2022-05-12 smallant2015
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    2021-08-07 小小的丁香花

    很好的研究

    0

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    2021-07-19 misszhang

    谢谢MedSci提供最新的资讯

    0

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