焦虑状态对2型糖尿病患者糖代谢和炎症及应激指标的影响

Impact of anxiety state on glycometabolism,inflammation and stress index in patients with type 2 diabetes mellitus

目的探讨焦虑状态对2型糖尿病(T_(2)DM)患者糖代谢和炎症及应激指标的影响。方法选取2020年1—12月在首都医科大学附属北京安贞医院接受治疗的T;DM患者128例进行研究。经焦虑自评量表(SAS)进行焦虑评估后,<50分纳入正常组(30例),50~69分纳入轻中度焦虑组(60例),≥70分纳入重度焦虑组(38例)。比较各组主要血糖指标、微炎症指标、氧化应激指标水平,分析焦虑严重程度与各指标的相关性。结果轻中度焦虑组、重度焦虑组空腹血糖、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)及丙二醛水平均高于正常组[其中HbA1c:(6.86±0.20)%、(8.65±0.28)%比(5.01±0.13)%,CRP:(40.3±6.6)、(61.0±8.6)mg/L比(9.2±1.2)mg/L;丙二醛:(7.8±0.6)、(12.0±0.9)μmol/L比(5.5±0.4)μmol/L],且重度焦虑组均高于轻中度焦虑组,差异均有统计学意义(均P<0.05);超氧化物歧化酶(SOD)、过氧化氢酶水平均低于正常组,且重度焦虑组均低于轻中度焦虑组,差异均有统计学意义(均P<0.05)。Pearson相关性分析结果显示,T;DM患者的焦虑程度与空腹血糖、2 hPG、HbA1c、CRP、IL-6、TNF-α、丙二醛水平呈正相关,与SOD、过氧化氢酶水平呈负相关(均P<0.05)。结论T;DM患者焦虑状态与机体糖代谢、微炎症以及氧化应激状态密切相关。

Objective To investigate the impact of anxiety state on glycometabolism,inflammation and stress index in patients with type 2 diabetes mellitus(T_(2)DM).Methods Totally 128 patients with T;DM admitted to Beijing Anzhen Hospital,Capital Medical University from January to December 2020 were selected.After anxiety assessment by self-rating anxiety scale(SAS),patients with SAS score<50 were included in the normal group(30 cases),with SAS score 50-69 were included in the mild and moderate anxiety group(60 cases),and with SAS score≥70 were included in the severe anxiety group(38 cases).Main blood glucose indexes,micro-inflammation indexes and oxidative stress indexes were compared among the groups,and the correlation between anxiety severity and each index was analyzed.Results The levels of fasting blood glucose,2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1 c),C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)in the mild and moderate anxiety group and severe anxiety group were higher than those in the normal group[HbA1 c:(6.86±0.20)%,(8.65±0.28)%vs(5.01±0.13)%;CRP:(40.3±6.6),(61.0±8.6)mg/L vs(9.2±1.2)mg/L;malondialdehyde:(7.8±0.6),(12.0±0.9)μmol/L vs(5.5±0.4)μmol/L],and the levels in the severe anxiety group were higher than those in the mild and moderate anxiety group(all P<0.05);the levels of superoxide dismutase(SOD)and catalase in the mild and moderate anxiety group and severe anxiety group were lower than those in the normal group,and the levels in the severe anxiety group were lower than those in the mild and moderate anxiety group(all P<0.05).Pearson correlation analysis showed that the degree of anxiety was positively correlated with levels of fasting blood glucose,2 hPG,HbA1 c,CRP,IL-6,TNF-α and malondialdehyde in patients with T;DM,and negatively correlated with levels of SOD and catalase(all P<0.05).Conclusion Anxiety state in T;DM patients is closely related with glycometabolism,micro-inflammation and oxidative stress state.