维生素D缺乏介导2型糖尿病合并抑郁症的病理生理机制与干预靶点

Vitamin D deficiency:a pathophysiological hub linking T2DM and depression and an emerging therapeutic target

摘要

2型糖尿病(T2DM)与抑郁症共病率高,显著加重治疗难度影响疾病预后,已成为全球公共卫生重大挑战。传统机制未能完全解释其共病本质。维生素D缺乏作为一个新兴的、具有多重生物学效应的共同病理生理枢纽,成为理解和管理该共病的关键切入点。维生素D通过其受体介导的抗炎、抗氧化、神经营养及免疫调节通路,同时作用于T2DM与抑郁症发病核心环节,从而构建一个统一机制框架。尽管多项观察性研究支持维生素D缺乏与共病风险显著相关,但干预性研究结果尚不一致,可能与人群异质性、研究方法的局限性等因素有关。本文系统整合现有证据,旨在为临床通过维生素D补充及综合管理改善共病预后提供理论依据,呼吁未来开展高质量及个体化治疗策略研究,以推动该领域向循证医学与实践转化。

Abstract

The high comorbidity rate between type 2 diabetes mellitus (T2DM) and depression substantially exacerbates treatment complexity and disease prognosis,posing a major global public health challenge.Traditional mechanistic models have failed to fully elucidate the shared pathophysiology underlying this comorbidity.Vitamin D deficiency,recognized as an emerging common pathophysiological hub with pleiotropic biological effects,serves as a critical entry point for understanding and managing this dual burden.Through its receptor-mediated anti-inflammatory,antioxidative,neurotrophic,and immunomodulatory pathways,vitamin D simultaneously targets core pathogenic processes in both T2DM and depression,thereby establishing a unified mechanistic framework.Although numerous observational studies robustly associate vitamin D deficiency with increased comorbid risk,interventional trial findings remain inconsistent-likely attributable to population heterogeneity and methodological constraints.This article systematically synthesizes available evidence to provide a theoretical rationale for improving comorbid outcomes via vitamin D supplementation and integrated clinical management,and underscores the urgent need for high-quality,personalized therapeutic strategies to advance the field toward evidence-based translation and clinical practice.

关键词

2型糖尿病 / 抑郁症 / 维生素D缺乏 / 共病 / 病理生理机制 / 干预靶点

Key words

Type 2 diabetes mellitus / Depression / Vitamin D deficiency / Comorbidity / Pathophysiological mechanism / Therapeutic target

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基金资助

新疆维吾尔自治区自然科学基金资助项目(2020D03006)