Title : The association of Type 1 Diabetes(T1DM), Celiac Disease (CD) with the subsequent development of depression: A systematic review and meta-analysis
Abstract:
The incidence of depression in individuals with T1DMM and CD has not been clearly studied. Extensive evidence shows that Depression is the most common psychiatric comorbidity among youth with T1DM and is more prevalent in children and adolescents with diabetes than in the general population and this high occurrence of depression is also seen in CD. In most studies with T1DM and CD in relation to depression, incidence has not been considered when calculating risk estimates so the clear association was difficult to understand . Comorbidity with Depression is a key determinant of impaired quality of life in T1DMM and CD. Therefore, it is essential to have a thorough understanding of these common autoimmune diseases with shared background and with high chronic disease burden. This study will independently evaluate depression incidence in T1DM and CD patients. Thus, the aim of this systematic review and meta-analysis is to independently investigate the association of T1DMM and CD in the development of depression. To best of our knowledge there are no previous systematic review and meta-analysis that study incidence between exposure and outcome. Overall, our results demonstrated that both T1DM and CD are associated with increased risks depression than individuals without T1DM or CD. A fitted random effects meta-analysis was conducted using data from 8 studies with T1DM as an Exposure. The meta-analysis using random-effects model revealed a statistically significant pooled Hazard Ratio. Individuals with T1DM have a 2.77-fold increased instantaneous risk of developing depression compared to those without T1DM. (HR = 2.77, 95% CI: 1.82–4.21, P < 0.05). The heterogeneity test results revealed I2 = 98.5% and with significant Q test P <.0001, indicating significant heterogeneity across the studies. The relationship between Celiac Disease and depression was also evaluated. The instantaneous risk of developing depression is 1.66 times higher for individuals with CD compared to those without CD, (pooled HR = 1.66, 95% CI: 1.51–1.84, P <0.0001). The heterogeneity test results revealed I2 = 35.3% and P = 0.2138, not statistically significant and indicating low heterogeneity among the studies. In summary, the present study indicated that the significant predisposition conferred by CD and T1DM in developing depression. The findings have important implications for both research and clinical practice. Clinicians could consider incorporating depression risk assessment, with more targeted screening towards individuals with type 1 diabetes and celiac disease. Public health efforts should focus on raising awareness and promoting preventive measures, for individuals with T1DM and CD. Early screening, in addition to these measurements, may help improve outcomes for individuals at risk of depression.
