中老年人糖尿病与抑郁状态共病:睡眠和运动及社交活动的影响研究  

Comorbidity of Diabetes and Depression in Middle-aged and Elderly People:the Impact of Sleep,Exercise,and Social Activities

作　　者：扶蓉 石磊 何飞英 FU Rong;SHI Lei;HE Feiying(School of Health Management,Southern Medical University,Guangzhou 510515,China;School of Health Management,Guangzhou Medical University,Guangzhou 511436,China;Social Science Key Laboratory of Guangdong Higher Education Institutes for Health Management Policy and Precision Health Services,Southern Medical University,Guangzhou 510515,China;Social Science Key Laboratory of Guangdong Higher Education Institutes for Health Governance Based on Big Data Utilization,Guangzhou Medical University,Guangzhou 511436,China;Guangdong-Hong Kong-Macao Greater Bay Area Medical and Health Industry High Quality Development Rule of Law Guarantee Research Center,Guangzhou Medical University,Guangzhou 511436,China)

机构地区：[1]广东省广州市,南方医科大学卫生管理学院,510515 [2]广州医科大学卫生管理学院,广东省广州市511436 [3]广东省高校健康管理政策与精准健康服务协同创新研究哲学社会科学重点实验室,广东省广州市510515 [4]广东省高校基于大数据利用的卫生健康治理哲学社会科学重点实验室,广东省广州市511436 [5]粤港澳大湾区医药健康产(行)业高质量发展法治保障研究中心,广东省广州市511436

出　　处：《中国全科医学》2025年第20期2491-2500,共10页Chinese General Practice

基　　金：国家自然科学基金资助项目(72104098);广东省哲学社会科学“十三五”规划项目(GD20XGL42);《佛山市促进高校科技成果服务产业发展扶持办法》创新研究项目(2024SWYY01)。

摘　　要：背景糖尿病和抑郁症是全球性公共卫生问题。糖尿病与抑郁症显著相关,因此对中老年人糖尿病、抑郁及糖尿病和抑郁共病进行监测和干预至关重要。目的探究中老年人糖尿病、抑郁状态及其共病患病率,以及睡眠、运动和社交活动对其的影响。方法基于2018年中国健康与养老追踪调查项目,纳入≥45岁中老年人为研究对象。收集其一般资料和糖尿病、抑郁状态患病情况及睡眠时长、运动、社交活动情况。采用多因素Logistic回归分析模型研究睡眠、运动和社交活动与糖尿病和抑郁状态共病之间的关联,将午睡时长和夜间睡眠时长的乘积纳入回归模型中进行交互作用分析。结果共纳入11177名为研究对象,其中糖尿病患病率为13.95%(1559/11177),抑郁状态患病率为24.85%(2777/11177),糖尿病和抑郁状态共病患病率为14.64%(1636/11177)。多元无序Logistic回归结果显示,夜间睡眠时长7~9 h(OR=0.337,95%CI=0.296~0.384)、夜间睡眠时长>9 h(OR=0.509,95%CI=0.374~0.692)以及午睡时长≥90 min(OR=0.792,95%CI=0.666~0.941)均是糖尿病和抑郁状态共病的保护因素(P<0.05);高水平社交同样能降低患共病的风险(OR=0.778,95%CI=0.686~0.882,P<0.05)。交互作用分析结果显示,保持7~9 h夜间睡眠时长,无论午休时间长短,均能有效降低糖尿病和抑郁状态共病患病风险(P<0.001);若夜间睡眠时长<7 h,午睡时长为60~<90 min能降低共病患病风险(OR=0.740,95%CI=0.577~0.950,P<0.05);在夜间睡眠时长>9 h,不午睡(OR=0.270,95%CI=0.125~0.581)或者保持60~<90 min的午睡时长(OR=0.165,95%CI=0.040~0.674)同样能够降低共病患病风险(P<0.05)。结论我国中老年人糖尿病和抑郁状态共病患病率较高,夜间睡眠时长≥7 h、午睡时长≥90 min以及高水平社交能有效降低糖尿病和抑郁状态共病患病风险,中等水平体力活动可分别降低糖尿病和抑郁状态患病风险。午睡则作为一种补偿机制,有助于Background Diabetes and depression are global public health issues.There is a significant correlation between diabetes and depression.Therefore,monitoring and intervening in diabetes,depression,and their comorbidity among middle-aged and elderly people is crucial.Objective To explores the prevalence of diabetes and depression,as well as their comorbidity,among the elderly population,and the impact of sleep,exercise,and social activities on these conditions.Methods Based on the 2018 China Health and Retirement Longitudinal Study,11177 participants who met the research criteria were included as subjects.A multifactorial Logistic regression analysis model was employed to investigate the association between sleep,exercise,and social activities with the comorbidity of diabetes and depression.Subsequently,the product of nap duration and nighttime sleep duration was incorporated into the regression model for interaction analysis.Results A total of 11177 subjects were included in the study,with a prevalence of diabetes of 13.95%(1559/11177),a prevalence of depressive status of 24.85%(2777/11177),and a comorbidity prevalence of both diabetes and depressive status of 14.64%(1636/11177).The results of the multinomial Logistic regression analysis indicated that a nighttime sleep duration of 7 to 9 hours(OR=0.337,95%CI=0.296-0.384),a nighttime sleep duration greater than 9 hours(OR=0.509,95%CI=0.374-0.692),and a nap duration greater than 90 minutes(OR=0.792,95%CI=0.666-0.941)were all protective factors for the comorbidity of diabetes and depressive status.High levels of social interaction were also found to reduce the risk of comorbidity(OR=0.778,95%CI=0.686-0.882,P<0.05).The interaction analysis results showed that maintaining a nighttime sleep duration of 7 to 9 hours,regardless of nap duration,was effective in preventing the comorbidity of diabetes and depressive status(P<0.001).If the nighttime sleep duration is less than 7 hours,a nap duration of 60 to 90 minutes can also reduce the risk of comorbidity(OR=0.740,95%CI=0.5

关 键 词：糖尿病 抑郁 慢性病共病 睡眠 体力活动 社交活动 健康管理 

分 类 号：R587.1[医药卫生—内分泌] R749.42[医药卫生—内科学]