2型糖尿病患者血糖波动与抑郁状态的相关性

Relationships between blood glucose fluctuation and depression in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血糖波动情况与抑郁状态的相关性。方法选取2015-08至2016-09就诊医院内分泌科T2DM患者42例为T2DM组,选择年龄、性别相匹配的健康志愿者28名为对照组,对所有患者进行连续72 h动态血糖监测(continuous glucose monitoring system,CGMS);均行蒙哥马利抑郁评定量表(Montgomery and Asberg depression rating scale,MADRS)评分。比较两组MADRS评分、血糖波动参数,并分析T2DM组血糖波动参数与MADRS的相关性。结果 T2DM组MADRS评分为(15.67±7.43)分,对照组MADRS评分为(8.29±3.76)分,T2DM组高于对照组,差异有统计学意义(t=4.818,P<0.01)。T2DM组与对照组相比,平均血糖波动幅度(mean amplitude of plasma glucose excursions,MAGE)、全天血糖水平标准差(standard deviation of blood glucose,SDBG)、最大血糖波动幅度(largest amplitude of plasma glucose excursions,LAGE)、日间血糖平均绝对差(means of daily differences,MODD)、平均餐后血糖波动幅度(mean amplitude of plasma postprandial blood Glucose excursions,MPPGE)均明显升高,差异有统计学意义(P<0.01)。T2DM患者MAGE与MADRS评分呈正相关(r=0.330,P<0.05)。结论 MAGE与抑郁的发生有关。

Objective To explore the correlations between blood glucose fluctuation and depression in patients with type 2 diabetes mellitus. Methods A total of 42 patients with type 2 diabetes mellitus were monitored for 72 h with the continuous glucose monitoring system（CGMS） between August 2015 and September 2016. Another 28 volunteers who matched the subjects in age and gender were chosen as the control. The Montgomery-Asberg depression rating scale（MADRS） was used to assess the score. MADRS scores and blood glucose fluctuation parameters were compared between the two groups,and the correlations between blood glucose fluctuation parameters and MADRS in the T2 DM group were analyzed. Results The MADRS score was（15. 67 ± 7. 43） in the T2 DM group,but was（8. 29 ± 3. 76） points in the control group,so the difference was statistically significant（t = 4. 818,P 0. 01）. Compared with the control group,MAGE,SDBG,LAGE,MODD and MPPGE in the T2 DM group were significantly increased,and the difference was also statistically significant（P 0. 01）. MADRS scores were positively correlated with blood fluctuation（MAGE）（r = 0. 330,P 0. 05） in the T2 DM group. Conclusions Blood glucose fluctuations（MAGE） are associated with depression in patients with type 2 mellitus.