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Shi L, Jia F. Association between antidepressant use and liver fibrosis in patients with type 2 diabetes: a population based study. Diabetol Metab Syndr 2023; 15:45. [PMID: 36899407 PMCID: PMC10007740 DOI: 10.1186/s13098-023-01016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/04/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND The prevalence of liver fibrosis among diabetic patients is increasing rapidly. Our study aims at exploring the relationship between antidepressant use and liver fibrosis in diabetic patients. METHODS We conducted this cross-sectional study through the cycle of National Health and Nutrition Examination Survey (NHANES) 2017-2018. The study population were consisted of patients with type 2 diabetes and reliable vibration-controlled transient elastography (VCTE) results. The presence of liver fibrosis and steatosis were assessed by the median values of liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), respectively. Antidepressants included selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and serotonin antagonists and reuptake inhibitors (SARIs). Patients with evidence of viral hepatitis and significant alcohol consumption were excluded. Logistic regression analysis was performed to evaluate the association between antidepressant use and both steatosis and significant (≥ F3) liver fibrosis after adjustment for potential confounders. RESULTS Our study population consisted of 340 women and 414 men, of whom 87 women(61.3%) and 55(38.7%) men received antidepressants. The most commonly used antidepressants were SSNIs(48.6%), SNRIs(22.5%) and TCAs(12.7%), followed by SARIs(10.6%) and other antidepressants(5.6%). 165 participants had significant liver fibrosis by VCTE, with a weighted overall prevalence of 24%(95% CI 19.2-29.5). In addition, 510 patients had evidence of hepatic steatosis by VCTE with a weighted overall prevalence of 75.4%(95% CI 69.2-80.7). After adjusting confounders, no significant association was observed between antidepressant use and significant liver fibrosis or cirrhosis. CONCLUSIONS In conclusion, in this cross-sectional study, we found that antidepressant drugs was not associated with liver fibrosis and cirrhosis in patients with type 2 diabetes in a nationwide population.
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Affiliation(s)
- Lin Shi
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Fangyuan Jia
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Wang Y, Liu D, Li X, Liu Y, Wu Y. Antidepressants use and the risk of type 2 diabetes mellitus: A systematic review and meta-analysis. J Affect Disord 2021; 287:41-53. [PMID: 33773358 DOI: 10.1016/j.jad.2021.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study aimed at examining the effects of different antidepressants on the new onset of T2DM. METHODS Systematic literature retrieval for cohort and case-control studies was conducted in PubMed, Embase, Web of Science, Cochrane library, Clinical Trials Register of the Cochrane Collaboration and CENTRAL published from January 2000 to October 2020. Pooled estimates were calculated and subgroup analyses were conducted by a fixed or random effects model according to the heterogeneity. Funnel plots and Egger's test were performed to evaluate publication bias. Stata Version 15.1 was used for data analysis. RESULTS Thirty studies (24 cohort, 4 nested case-control and 2 case-control studies) were included covering 2,875,567 participants with the follow-up periods from 1 year to 18 years (Median=8.4 years). The pooled estimates of antidepressants use and new-onset T2DM were HR=1.24 (95% CI: 1.18, 1.31), RR=1.42 (95% CI: 0.99, 2.05) and OR=1.17 (95% CI: 1.03, 1.32), respectively. However, subgroup analyses showed that only tricyclic antidepressants (TCAs) use was positively associated with the new onset of T2DM in both cohort studies (combined RR=1.39, 95% CI: 1.17, 1.65) and case-control studies (combined OR=1.25, 95% CI: 1.05, 1.50). Moreover, the risk of T2DM was increased with the duration of antidepressants use in a linear trend (R2= 88.51%, P = 0.009). LIMITATIONS Heterogeneity might impact the results and inference. CONCLUSIONS Antidepressants use might be a risk factor for the new onset of T2DM. Patients with long-term antidepressants use should be evaluated cautiously for T2DM risk. Routine T2DM screening is necessary in antidepressants users.
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Affiliation(s)
- Yuqing Wang
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Debiao Liu
- Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Xuezhi Li
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Yan Liu
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Yili Wu
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China.
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