2型糖尿病患者焦虑状态和糖化血红蛋白的关系

Association of anxiety and hemoglobin A_1c in patients with type 2 diabetes mellitus

目的探讨T2DM患者焦虑状态和HbA_1c的关系。方法采用多阶段整群随机抽样方法,应用自行设计的一般情况调查表、焦虑抑郁状态自评量表对患者进行调查,并检测HbA_1c。采用多元逐步回归分析模型探讨焦虑状态和HbA_1c的关联。结果焦虑状态患者HbA在c达标率为17.90%(97/542),无焦虑状态患者达标率为25.65%(108/421),两者比较,比较差异有统计学意义(x^2=8.51,P=0.01)。无焦虑、轻度、中度和重度焦虑患者中,血糖达标的比例分别为25.65%(108/421)、18.96%(80/422)、15.18%(17/112)和0.00%(0/8)。T2DM患者焦虑状态程度越严重,患者血糖达标率越低(x^2_(趋势)=10.27,P<0.01),HbA_1c越高(F=4.24,P<0.01)。多元线性逐步回归分析发现,女性、独居、人均月收入低、病程长和焦虑状态是HbA_1c升高的危险因素。结论 T2DM患者焦虑状态与HbA_1c存在关联。

Objective To investigate the association between anxiety and hemoglobin A1c（HbA1c）in patients with type 2 diabetes mellitus（T2DM）.Methods Cluster sampling was used in this study.The self-designed questionnaire,self-rating anxiety scale（SAS） and self-rating depression scale（SDS）questionnaire were filled out by all participants.HbA1c were measured in all subjects.Multiple stepwise regression analyse was used to examine the association between anxiety and HbA1c.Results Target HbA1c achievement rate were significantly different in T2 DM patients with and without anxiety（17.89%vs 25.65%respectively,x^2= 8.51,P = 0.01）.Target HbA_1c achievement rates in patient with ＇no anxiety＇,＇mild anxiety＇,＇ moderate anxiety＇ and ＇ severe anxiety＇ were 25.65%,18.96%,15.18%and0.00%respectively.The more serious of anxiety,the lower glycemic control rate（χ^2trend = 10.27,P〈0.01）,and the higher average value of HbA1c（F=4.24,P〈0.01）.Multiple stepwise regression analysis showed that gender,residential pattern,per capita monthly income,duration of diabetes and anxiety were risk factors for HbA1c.Conclusion Anxiety is associated with HbA1c in T2 DM patients.