老年糖尿病患者睡眠时间与抑郁风险相关性研究

Association between Sleep Duration and Depression Risk in Elderly Patients with Diabetes

摘要

目的:探讨老年糖尿病患者的睡眠时间与抑郁风险之间的关联。方法:选取2005—2018年美国国家健康与营养检查调查数据库中60岁以上的糖尿病患者2 576例,根据患者健康问卷-9 (PHQ-9)评分将患者分为抑郁组(n=763)和非抑郁组(n=1 813)。收集患者基线资料、糖尿病相关指标、睡眠时间及PHQ-9评分,探讨老年糖尿病患者睡眠时间与抑郁风险之间的关系。结果:两组患者性别、受教育程度、贫困指数、身体质量指数、肾脏病史、心力衰竭病史、冠心病史、脑卒中史、肝脏疾病史及睡眠时间差异均具有统计学意义(均P<0.05)。将睡眠时间按四分位数法分组,结果显示,各睡眠时间段患者的PHQ-9评分和抑郁风险情况均有统计学差异(均P<0.001)。建立3个校正模型,结果均显示,睡眠时间与抑郁相关(均P<0.001)。在模型3中,睡眠时间每增加1个标准差,抑郁风险降低15%(OR=0.850, 95%CI: 0.797, 0.906)。相比 Q1 组,Q4 组(OR=0.661, 95%CI: 0.486, 0.905)抑郁风险显著降低。亚组分析显示,年龄与睡眠时间存在交互作用(P_交互 =0.037)。限制性立方样条回归分析显示,睡眠时间与PHQ-9评分之间呈 U 型关联,患者每天保证睡眠时长7.88 h可显著降低抑郁风险。结论:老年糖尿病患者睡眠时间与抑郁风险密切相关,适量睡眠对降低抑郁风险至关重要。在临床实践中应关注老年糖尿病患者的睡眠时间,进行早期干预以减少抑郁的发生,从而提升患者的生活质量。

Abstract

Objective: To explore the association between sleep duration and the risk of depression in elderly patients with diabetes. Methods: A total of 2 576 diabetic patients aged over 60 years from the National Health and Nutrition Examination Survey database from 2005 to 2018 were selected. According to the scores of the patient health questionnaire-9 (PHQ-9), the patients were divided into the depressive group (n=763) and the non-depressive group (n=1 813). Baseline data, diabetes-related indicators, sleep duration, and PHQ-9 scores of the patients were collected to explore the relationship between sleep duration and the risk of depression in elderly patients with diabetes. Results: There were significant differences in gender, educational level, poverty index, body mass index, history of kidney disease, history of heart failure, history of coronary heart disease, history of stroke, history of liver disease, and sleep duration between the two groups (all P<0.05). When sleep duration was grouped by the quartile method, the results showed that there were significant differences in PHQ-9 scores and the risk of depression among patients in four sleep time periods (both P<0.001). Three correction models were established, and the results all showed that sleep duration was related to depression (all P<0.001). In model 3, each 1-standard-deviation increase in sleep duration was associated with a 15% (OR=0.850, 95%CI: 0.797, 0.906) reduction in the risk of depression, and the Q4 group (OR=0.661, 95%CI: 0.486, 0.905) showed a significant reduction in the risk of depression compared with Q1 group. Subgroup analysis showed that there was an interaction between age and sleep (P _interaction=0.037). Restricted cubic spline regression analysis showed a U-shaped association between sleep duration and PHQ-9 scores, and a sleep duration of 7.88 hours per day could significantly reduce the risk of depression. Conclusion: Sleep duration is closely related to the risk of depression in elderly patients with diabetes. Appropriate sleep is crucial for reducing the risk of depression. In clinical practice, attention should be paid to the sleep duration of elderly patients with diabetes, and early intervention should be carried out to reduce the occurrence of depression, thereby improving the quality of life of patients.

关键词

老年 / 糖尿病 / 睡眠时间 / 抑郁风险

Key words

elderly / diabetes / sleep duration / risk of depression

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基金资助

湖北省教育厅科学研究计划指导性项目(B2019016)

宜昌市2025年度社会科学课题项目(ysk25kt266)