2型糖尿病患者合并抑郁障碍的影响因素

Factors Influencing Comorbid Depressive Disorders in Patients with Type 2 Diabetes

目的:了解三级综合医院门诊2型糖尿病(type 2 diabetes mellitus,T2DM)患者共病抑郁障碍的患病率和相关危险因素。方法:选取2019年1—12月航空总医院内分泌科门诊就诊的158例T2DM患者作为研究对象。观察指标有年龄、性别、吸烟、糖尿病病程、婚姻状态、胰岛素治疗、焦虑、超重和肥胖、高血压史、冠心病史、痛风史、糖尿病并发症、非酒精性脂肪肝、糖化血红蛋白(HemoglobinA1c,HbA1c)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density liptein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)等。结果:T2DM患者抑郁障碍的患病率为39.24%,其中重度抑郁占19.35%。单因素分析显示,抑郁组的糖尿病患者的年龄显著高于非抑郁组,抑郁组的糖尿病病程比非抑郁组的长,差异有统计学意义(t=2.480、2.053,P<0.05);抑郁组有两个以上并发症的比例高于非抑郁组,抑郁组HbA1c高于非抑郁组,差异有统计学意义(χ^(2)=7.588;t=2.420,P<0.05)。多因素logistic回归分析显示,年龄(OR=1.051,95%CI:1.012~1.069,P=0.01)和HbA1c (OR=1.184,95%CI:1.016~1.379,P=0.031)均与抑郁呈正相关关系。结论:在T2DM患者中,抑郁障碍的患病率为39.24%,此类患者在日常门诊的识别率极低,T2DM患者共病抑郁的危险因素有增龄和HbA1c。

Objective:To investigate the prevalence and related risk factors of comorbidities of depressive disorder in outpatients with type 2 diabetes mellitus(T2DM) in tertiary general hospitals.Methods:158 patients with T2DM who visited the hospital from January-December 2019 were selected as the study population.The observed indicators were age,gender,smoking,duration of diabetes,marital status,insulin therapy,anxiety,overweight and obesity,history of hypertension,history of coronary heart disease,history of gout,complications of diabetes,non-alcoholic fatty liver,HemoglobinA1c(HbA1c),total cholesterol(TC),triglyceride(TG) low density liptein cholesterol(LDL-C),high density liptein cholesterol(HDL-C),etc.Results:The prevalence of depressive disorder in patients with T2DM was 39.24%,with major depression accounting for 19.35%.Univariate analysis showed that the age of diabetic patients in the depressed group was significantly higher than in the non-depressed group,and the duration of diabetes was longer in the depressed group than in the non-depressed group,with statistically significant differences(t=2.480,2.053,P<0.05).The percentage of depressed group with more than two complications was higher than the non-depressed group,and the HbA1c was higher in the depressed group than in the non-depressed group,with a statistically significant difference(χ^(2)=7.588;t=2.420,P<0.05).Multivariate logistic regression analysis showed that both age(OR=1.051,95%CI:1.012-1.069,P=0.01) and HbA1c(OR=1.184,95%CI:1.016-1.379,P=0.031) were positively associated with depression.Conclusion:In patients with T2DM,the prevalence of depressive disorders was 39.24%,and the identification of such patients in daily outpatient clinics was extremely low.Risk factors for co-morbid depression in patients with T2DM were increased age and HbA1c.