共病2型糖尿病的老年期抑郁障碍患者血糖波动及与脂代谢特征的相关性研究

Study on the correlation between blood glucose fluctuation and lipid metabolism characteristics in elderly patients with depressive disorder complicated with type 2 diabetes mellitus

目的探讨共病2型糖尿病(T2DM)的老年期抑郁障碍患者血糖波动及与脂代谢特征的相关性。方法选取2020年1月至2023年4月于安徽医科大学附属心理医院老年心理科住院的67例共病T2DM的老年期抑郁障碍患者为病例组,同期选取在安徽医科大学第一附属医院老年内分泌科住院的67例单纯T2DM患者为对照组。比较两组的脂代谢、连续血糖监测(CGM)指标及焦虑、抑郁评分;用多元线性回归分析血糖波动与脂代谢指标的相关性。结果病例组的总胆固醇水平、变异系数(CV)、低血糖指数(LBGI)及汉密尔顿抑郁量表24项版本(HAMD-24)、汉密尔顿焦虑量表(HAMA)评分高于对照组,高密度脂蛋白、载脂蛋白A1水平低于对照组(P<0.05)。HAMD-24评分、LBGI与总胆固醇呈正相关(P<0.05);HAMA评分、CV与高密度脂蛋白呈负相关(P<0.05);HAMD-24评分、CV与载脂蛋白A1呈负相关(P<0.05)。结论共病T2DM的老年期抑郁障碍患者脂代谢存在异常,血糖波动明显,血糖波动与脂代谢异常密切相关。

Objective To investigate the correlation between blood glucose fluctuation and lipid metabolism characteristics in elderly patients with depressive disorder complicated with type 2 diabetes mellitus(T2DM).Methods From January 2020 to April 2023,67 elderly patients with depressive disorder complicated with T2DM who were hospitalized in the geriatric psychology department of the Affiliated Psychological Hospital of Anhui Medical University were selected as case group,and 67 patients with simple T2DM who were hospitalized in the geriatric endocrinology department of the First Affiliated Hospital of Anhui Medical University were selected as control group.The lipid metabolism,continuous glucose monitoring(CGM)indexes,anxiety and depression scores were compared between the two groups;multiple linear regression was used to analyze the correlation between blood glucose fluctuation and lipid metabolism indexes.Results The total cholesterol level,coefficient of variation(CV),low blood glucose index(LBGI)and the scores of Hamilton Depression Scale-24(HAMD-24)and Hamilton Anxiety Scale(HAMA)in the case group were higher than those in the control group,while the levels of high-density lipoprotein and apolipoprotein A1 were lower than those in the control group(P<0.05).The HAMD-24 score and LBGI were positively correlated with total cholesterol(P<0.05);HAMA score and CV were negatively correlated with high density lipoprotein(P<0.05);HAMD-24 score and CV were negatively correlated with apolipoprotein A1(P<0.05).Conclusion The elderly patients with depressive disorder complicated with T2DM have abnormal lipid metabolism and significant blood glucose fluctuation.Blood glucose fluctuation is closely related to abnormal lipid metabolism.