(A-314) Association between depression and use of sodium-glucose cotransporter-2 inhibitors using target trial emulation: population-based cohort study

Background: The association between sodium-glucose co-transporter 2 inhibitors (SGLT-2i) and depression incidence has not been assessed in the Chinese population.

Objectives: We aimed to assess the effects of SGLT-2i on the risk of depression.

Methods: We emulated a target trail of SGLT-2i vs DPP-4i. A cohort of T2DM patients who were new users of SGLT-2i or dipeptidyl peptidase 4 inhibitors (DPP-4i) was assembled by using the Yinzhou Regional Health Care Database. A Cox model with inverse probability of treatment weighting (IPTW) was applied for estimating the hazard ratio (HR), with a 95% confidence interval (CI) of the association between the use of SGLT-2i and incident depression.

Results: A total of 1039 incident depression cases occurred during a mean follow-up of 2.3 years. The incidence of depression was 95.6 per 10,000 person-years (PYs) in DPP-4i users and 79.4 per 10,000 PYs in SGLT-2i users respectively. The cohort included 23508 new users of SGLT-2is and 27166 new users of DPP-4is. In the primary analysis, the incidence of depression was 500.2 and 347.5 per 100,000 person-years in users of DPP-4is and SGLT-2is respectively. SGLT-2i was presented to reduce 15% of the risk of depression after controlling potential confounding using IPTW (HR 0.85; 95% CI, 0.74-0.97). The results were generally consistent in subgroup analyses and sensitivity analyses.

Conclusions: The use of SGLT-2is is associated with a decreased risk of depression incidence in a mainland Chinese population. More studies with higher validity of depression diagnosis are needed in the future.