Aims

Several psychiatric disorders are linked with an increased risk of developing type 2 diabetes (T2D), but the mediating mechanisms are unclear. We aimed to investigate health behaviors, obesity, psychotropic medication use, and comorbidity as potential mediating mechanisms explaining these associations.

Methods

We combined data from a large population-based survey with register-based data and followed a sample of 250,013 Danes (≥16 years) for up to 8.9 years. We conducted mediation analyses investigating 10 potential mediators of the associations between psychiatric disorders and incident T2D.

Results

Individuals with a substance use disorder, schizophrenia, mood disorder, neurotic disorder, eating disorder, or a personality disorder had a significantly higher risk of developing T2D. Organic disorders, intellectual disabilities, developmental and behavioral disorders were not associated with T2D-risk. For all psychiatric disorders significantly associated with T2D, the use of antidepressant medication had the largest proportional mediating effect on the association (13–32 %).

Conclusions

Use of antidepressant medication had the largest contribution to the associations between psychiatric disorders and incident T2D. Future epidemiological studies and prevention studies should focus on optimizing the use of antidepressant medication with minimal side effects, and the promotion of health behaviors in individuals with a psychiatric disorder to prevent T2D.

中文翻译：

---

精神疾病患者患 2 型糖尿病的风险增加：健康行为和精神药物的作用是什么？

目标

多种精神疾病与 2 型糖尿病 (T2D) 风险增加有关，但其介导机制尚不清楚。我们的目的是调查健康行为、肥胖、精神药物的使用和合并症，作为解释这些关联的潜在中介机制。

方法

我们将大规模人口调查的数据与登记数据相结合，对 250,013 名丹麦人（≥16 岁）进行了长达 8.9 年的跟踪调查。我们进行了中介分析，调查了精神疾病与 T2D 事件之间关联的 10 个潜在中介因素。

结果

患有药物滥用障碍、精神分裂症、情绪障碍、神经症、饮食障碍或人格障碍的个体患 T2D 的风险明显更高。器质性障碍、智力障碍、发育和行为障碍与 T2D 风险无关。对于所有与 T2D 显着相关的精神疾病，抗抑郁药物的使用对这种关联具有最大的比例中介效应 (13-32%)。

结论

抗抑郁药物的使用对精神疾病和 T2D 事件之间的关联影响最大。未来的流行病学研究和预防研究应侧重于优化副作用最小的抗抑郁药物的使用，以及促进精神疾病患者的健康行为以预防 T2D。