Assessing the longitudinal associations and stability of smoking and depression syndrome over a 4-year period in a community sample with type 2 diabetes 在一个社区2型糖尿病样本中进行的为期4年的吸烟与抑郁综合征之间的纵向相关性以及稳定性的评估

Background The aim of the present study was to investigate the stability and longitudinal association between depression and smoking status within a community sample with type 2 diabetes (T2D) while controlling for sociodemographic and disease-related variables. Methods Adults with T2D were recruited and agreed to be followed-up via random digit dialing for the Montreal Diabetes Health Study. At baseline, 1614 individuals were classified as never (n = 592), former (n = 690), light (≤10 cigarettes a day; n = 128) and moderate–heavy (11+ cigarettes a day; n = 204) smokers. Depression was assessed using the Patient Health Questionnaire-9 and individuals were classified as either “none” or having depression syndrome. Generalized estimating equations were used to test the association between depression syndrome and current smoking status while controlling for other demographic and health-related variables. Results Prevalence rates of smoking and depression showed mild to substantial agreement over time. Depression syndrome was significantly associated with moderate–heavy smoking in the fully adjusted model using cross-sectional (all four waves; odds ratio [OR] 1.46; 95% confidence interval [CI] 1.08–1.99; P < 0.05) and longitudinal (controlling for depression at baseline; OR 1.54; 95% CI 1.02–2.31; P < 0.05) data. Conclusions Smoking and depression prevalence rates appear to be stable over time in our community sample with T2D. Moderate–heavy smoking is strongly associated with elevated depression, both in cross-sectional and longitudinal models. Persistent moderate–heavy smokers may be at increased risk of both physical and mental health complications. This burden is even greater for those with T2D. 摘要 背景：本研究的目的是在一个社区2型糖尿病样本中调查经过社会人口统计学以及疾病相关变量校正之后的抑郁症与吸烟状态之间的稳定性以及纵向相关性。 方法：招募入组的2型糖尿病成年患者在知情同意之后通过蒙特利尔糖尿病健康研究的随机数字拨号系统进行随访。在基线时，将1614名患者分为从未吸烟者（n = 592）、曾经吸烟者（n = 690）、轻度吸烟者（每日≤10支香烟；n = 128）以及中-重度吸烟者（每日11+支香烟；n = 204）。使用患者健康调查表-9来评估抑郁症，将患者分为“无”或者“有”抑郁综合征。使用广义估计方程式，校正人口统计学以及健康相关变量后评估抑郁综合征与当前吸烟状态之间的关系。 结果：随着时间的推移，吸烟与抑郁症的患病率表现出了轻度至重度的一致性。在完全校正的模型中，无论是使用横断面数据（所有的4波；优势比[OR] ：1.46；95%可信区间[CI]：1.08-1.99；P < 0.05）还是使用纵向数据（考虑到了基线时的抑郁症；OR：1.54；95% CI：1.02–2.31；P < 0.05），抑郁综合征与中-重度吸烟之间都有显著的相关性。 结论：在我们的社区2型糖尿病样本中，随着时间的推移吸烟与抑郁症的患病率似乎都很稳定。无论是在横断面模型还是在纵向模型中，中-重度吸烟都与抑郁症增加强烈相关。持续性中-重度吸烟者出现生理和心理方面并发症的风险都明显增加了。这种损害甚至比2型糖尿病所导致的损害更大。