2型糖尿病抑郁状况及影响因素分析

The Status of Depression in Patients with Type 2 Diabetes Mellitus and Its Influencing Factors

目的：分析2型糖尿病（T2DM）患者抑郁状况及影响因素。方法：纳入2014年3月-2016年2月我院收治132例T2DM患者,采集所有患者临床资料,包括人口学资料、病程、受教育程度、肾上腺功能、甲状腺功能、血糖、血脂、胰岛素水平等,比较T2DM抑郁与非抑郁情绪患者各临床指标的差异,分析T2DM抑郁的影响因素。结果：（1）132例T2DM患者中,发生抑郁52例（39.39%）,T2DM伴抑郁患者与非抑郁患者受教育程度（χ^2=4.154,P〈0.05）、T2DM病程（t=6.276,P〈0.01）、FPG（t=8.089,P〈0.01）、HbA 1c（t=4.752,P〈0.01）、FINS（t=8.612,P〈0.01）、HOMA-IR（t=7.745,P〈0.01）、TC（t=5.070,P〈0.01）、TG（t=5.823,P〈0.01）、LDL-C（t=6.267,P〈0.01）、Cor（t=2.489,P〈0.01）、ACTH（t=8.543,P〈0.01）、FT3（t=3.090,P〈0.05）存在明显差异,均有统计学意义。（2）Pearson相关性分析显示：T2DM病程、FPG、HbA 1c、FINS、HOMA-IR、TG、LDL-C、Cor、ACTH均与T2DM抑郁情绪呈正相关（r=0.319、0.332、0.514、0.668、0.345、0.462、0.641、0.451,P均〈0.05）,FT3与其呈负相关（r=-0.354,P均〈0.05）。（3）T2DM病程、FPG、HbA 1c、FINS、HOMA-IR、LDL-C、ACTH评分、FT3均为T2DM抑郁情绪的影响因素（OR=27.061、38.988、3.233、26.168、27.942、6.095、6.312、3.462,P均〈0.05）。结论：T2DM抑郁情绪与神经内分泌激素紊乱、胰岛素抵抗有关,且T2DM病程、糖脂代谢紊乱均可能导致T2DM患者产生抑郁情绪。

Objective： To analyze the status of depression in patients with type 2 diabetes mellitus（ T2DM） and its influencing factors.Methods： A total of 132 patients with T2DM treated in our hospital from March 2014 to February 2016 were enrolled in the study.The clinical data of all patients were collected,including demographic data,course of disease,education level,adrenal function,thyroid function,levels of blood glucose,blood lipids and insulin levels. The clinical indicators were compared between patients with T2DM depression and those without depression,and the influencing factors of depression in T2DM were analyzed.Results：（1）There were a total of 132 cases enrolled in the study,including 52 cases with depression,accounting for 39.39%. There were significant differences between patients with T2 DM and depression and those without depression in the educational level（ χ^2= 4.154,P〈0.05）,course of T2 DM（ t = 6.276,P〈0.01）,FPG（ t = 8.089,P〈0.01）,HbA 1 c（ t = 4.752 P〈0.01）,FINS（ t = 8.612,P〈0.01）,HOMA-IR（ t = 7.745,P〈0.01）,TC（ t = 5.070 P〈0.01）,TG（ t= 5.823,P〈0.01）,LDL-C（ t= 6.267,P〈0.01）,Cor（ t= 2.489,P〈0.01）,ACTH（ t = 8.543,P〈0.01）,FT3（ t = 3.090,P〈0.05）.（2）Pearson correlation analysis showed that the course of T2 DM,FPG,HbA 1 c,FINS,HOMA-IR,TG,LDL-C,Cor and ACTH were positively correlated with depression（ t = 0.319,0.332,0.514,0.668,0.345,0.462,0.641,0.451; P〈0.05）,and FT3 was negatively correlated with depression（ t = 0.354,P〈0.05）.（3）The course of T2 DM,FPG,HbA 1 c,FINS,HOMA-IR,LDL-C,and ACTH,FT3 were the influencing factors of depression in T2DM（ OR = 27.061,38.988,3.233,26.168,27.942,6.095,6.312,3.462; all P〈0.05）.Conclusion： Depression in T2DM is related to neuroendocrine disorders and insulin resistance,and the course of T2 DM and disorders of glucose and lipid metabolism may lead to depression in patients with T2DM.