糖尿病周围神经病变伴抑郁症状患者血清同型半胱氨酸与25-羟维生素D表达及其临床意义

Expressions of serum homocysteine and 25-hydroxyvitamin D in DPN patients combined with depressive symptoms and their clinical significance

目的探讨糖尿病周围神经病变(DPN)伴抑郁症状患者血清同型半胱氨酸(Hcy)与25-羟维生素D[25-(OH)D]表达及其临床意义。方法选取DPN伴抑郁症状患者50例设为研究组,DPN未伴有抑郁症状患者32例设为对照组。采用酶循环法检测Hcy水平,电化学发光法检测25-(OH)D水平。比较两组患者Hcy、25-(OH)D水平以及研究组不同抑郁程度患者Hcy、25-(OH)D水平差异。采用Pearson相关分析探讨DPN伴抑郁症状患者的Hcy、25-(OH)D水平与HADM-17评分的相关性,采用Logistic回归分析探讨DPN伴抑郁症状患者抑郁程度的影响因素。结果研究组患者Hcy水平、HAMD-17评分高于对照组,25-(OH)D水平低于对照组(P<0.01)。重度抑郁患者Hcy水平高于轻度、中度抑郁患者,25-(OH)D水平低于轻度、中度抑郁患者(P<0.05)。Pearson相关性分析显示,DPN伴抑郁症状患者Hcy水平与HAMD评分呈显著正相关(r=0.886,P<0.05),25-(OH)D水平与HAMD-17评分呈显著负相关(r=-0.619,P<0.05)。单因素分析结果显示,DPN伴抑郁症状患者性别、收缩压、空腹血糖、文化程度、Hcy、25-(OH)D水平比较,差异有统计学意义(P<0.05或0.01)。Logistic回归分析结果显示,性别、空腹血糖、文化程度、Hcy、25-(OH)D水平是DPN伴抑郁症状患者抑郁程度的影响因素(P<0.01)。结论DPN伴抑郁症状患者Hcy水平升高,25-(OH)D水平降低,性别、空腹血糖、文化程度是DPN伴抑郁症状患者抑郁程度的影响因素。Hcy和25-(OH)D表达在评估DPN患者抑郁严重程度方面具有重要价值,能为患者后续治疗提供生物学信息参考。

Objective To explore the expressions of serum homocysteine(Hcy)and 25-hydroxyvitamin D(25-(OH)D)in diabetic peripheral neuropathy(DPN)patients combined with depressive symptoms and their clinical significance.Methods Fifty DPN patients with depressive symptoms were selected as research group,and 32 ones without as control group.Hcy and 25-(OH)D levels were detected using enzymatic cycling method and electrochemiluminescence respectively.Hcy and 25-(OH)D levels were compared between the two groups and so were the differences in Hcy and 25-(OH)D levels among patients with different degrees of depression in research group.Cor relations of Hcy and 25-(OH)D levels with the score on the Hamilton Depression Scale(HAMD)were explored using Pea rson cor relation analysis,so were the inf luencing factors of depressive degrees in DPN patients with depressive symptoms using Logistic regression analysis.Results Hcy level and HAMD score were higher and 25-(OH)D was lower in research than cont rol group(P<0.01).Hcy levels were higher and 25-(OH)D lower in major depression patients than mild and moderate ones(P<0.05).Pearson correlation analysis showed that Hcy expression levels were significantly positively(r=0.886,P<0.05)and 25-(OH)D negatively(r=-0.619,P<0.05)correlated with HAMD score in DPN patients with depressive symptoms.Univariate analysis showed that differences in genders,systolic pressure,fasting blood glucose,educational levels,Hcy,and 25-(OH)D levels in DPN patients with depressive symptoms were statistically significant(P<0.05 or 0.01).Logistic regression analysis showed that genders,fasting blood glucose,educational levels,Hcy,and 25-(OH)D levels were the factors influencing depression degrees in DPN patients with depressive symptoms(P<0.01).Conclusion Hcy level elevates in DPN patients with depressive symptoms,25-(OH)D lowers,and gender,fasting blood glucose,and educational levels are the influencing factors of depression degrees.Hcy and 25-(OH)D expression are of great value in evaluating the severity of depression in DPN patients and can provide biological information reference for subsequent treatment of patients.