壮族人群糖尿病伴抑郁患病率及危险因素分析

Analysis of prevalence and risk factors of diabetics combined with depression in Zhuang nationality

目的本研究采用横断面调查分析,调查广西壮族人群中糖尿病患者并抑郁症的患病率,并对其危险因素进行分析,为糖尿病患者教育提供新观点及依据。方法共收集420例住院患者,其中男性264名,女性156例,年龄(53.3±12.63)岁,病程(4.13±3.27)年。使用医院焦虑抑郁量表(HAD)对其进行抑郁评分测量,非抑郁组0~7分,抑郁组8~21分,得出糖尿病患者抑郁症的患病率。对两组患者年龄、性别、体重指数、病程、吸烟、糖尿病教育、治疗方式、学历等一般情况及血压、血脂、糖化血红蛋白、C反应蛋白、尿白蛋白/肌酐比值(Urinary albumin/creatinine,ACR)等相关生化数据进行对比研究,并使用Logistic回归分析寻找其诱发抑郁的危险因素。结果 39.28%(165例)的患者存在不同程度的抑郁症状,其中男性108例,占65.45%,女性57例,占34.55%。两组间比较,抑郁组中年龄、舒张压、胱抑素C、极低密度脂蛋白、甘油三酯、糖化血红蛋白、C反应蛋白及ACR高于非抑郁组,差异有统计学意义(P<0.01)。使用二元Logistic回归分析,结果显示胱抑素C(OR=2.03,95%CI 1.11~3.71),舒张压(OR=1.05,95%CI 1.00~1.10),ACR(OR=1.03,95%CI 1.00~1.07)是糖尿病患者合并抑郁症的危险因素。而性别、体重指数、病程、吸烟、糖尿病教育等指标无显著相关性。结论广西壮族糖尿病患者中抑郁普遍存在,胱抑素C、舒张压及尿白蛋白/肌酐比值可能是这部分人群抑郁症发病的危险因素。

Objective Cross-sectional survey was conducted to investigate the prevalence of diabetics combined with depression in Zhuang nationality,and to analyze its risk factors,so as to provide new perspectives and basis for the education of patients with diabetes mellitus.Methods A total of 420 hospitalized patients were enrolled,which included 264 males and 156 females,aged(53.3±12.63)years,and the course of disease was(4.13±3.27)years.Hospital Anxiety and Depression Scale(HADS)was used to measure the depression score of the patients.The depression score was 0~7 in non depression group and 8~21 in depression group,and the prevalence of depression in diabetics patients was obtained.A comparative study was carried out on general situation like age,sex,body mass index,course of disease,smoking,diabetes education and treatment methods and educational background as well as related biochemical data like blood pressure,blood lipid,glycosylated hemoglobin,C reactive protein,urinary albumin/creatinine ratio(ACR)between the two groups.Meanwhile,Logistic regression analysis was used to find out the risk factors of depression.Results 39.28%(165 cases)of patients had varying degrees of depressive symptoms,of which 108 cases were male,accounting for 65.45%,and 57 cases were female,accounting for 34.55%.Age,diastolic blood pressure,cystatin C,VLDL,TG,HbA1c,CRP and ACR in the depression group were higher than those of the non depression group,difference was statistically significant(P<0.01).Binary Logistic analysis showed that cystatin C(OR=2.03,95%CI 1.11~3.71),diastolic pressure(OR=1.05,95%CI 1.00~1.10),ACR(OR=1.03,95%CI 1.00~1.07)were risk factors for depression in diabetic patients.And there was no significant correlation between sex,body mass index,course of disease,smoking,diabetes education,etc.Conclusion Diabetes patients with depression are prevalent in Guangxi Zhuang nationality,cystatin C,diastolic blood pressure and ACR are possible independent risk factors for the incidence of it.