摘要
目的探讨2型糖尿病合并抑郁症的相关危险因素及其与动脉硬化关系。方法收集184例2型糖尿病住院患者作为研究对象,入选对象均行HAMD-17量表测评,其中106例2型糖尿病合并抑郁症患者(符合CCMD-3抑郁症诊断标准,HAMD-17≥17分)为病例组,78例2型糖尿病未合并抑郁症患者(HAMD-17≤7分)为对照组;入选对象均行糖化血红蛋白(HbA1c)、血脂、C-反应蛋白(CRP)、颈动脉内膜中层厚度(IMT)等检测。分析2型糖尿病合并抑郁症的相关危险因素,及其与炎症、动脉硬化关系。结果 (1)2型糖尿病合并抑郁症组BMI较大、腹围较大、糖尿病微血管并发症发病率较对照组高、女性患者较多,治疗方式存在差异(P<0.05);2组年龄、糖尿病病程比较,差别无统计学意义(P>0.05);(2)2型糖尿病合并抑郁症组IMT、CRP、HbA1c明显高于对照组,差别具有统计学意义(P<0.05);2组血脂比较,差别无统计学意义(P>0.05);(3)多元线性回归分析结果显示:HAMD评分与IMT呈正相关,标准回归系数为0.234,P<0.05,与HbA1c呈正相关,标准回归系数为0.348,P<0.01,相关性均有统计学意义,HAMD评分与CRP无相关性,标准回归系数为0.030,P>0.05。结论 2型糖尿病患者中女性、肥胖、血糖控制不佳、微血管并发症、使用胰岛素治疗等都是与2型糖尿病合并抑郁症的相关因素;炎症、动脉硬化与抑郁症的发病过程有关,2型糖尿病合并抑郁症与糖尿病大血管病变和微血管病变均有相关。
Objective To investigate the risk factors of type 2 diabetes with depression and its re-lationship with atherosclerosis . Methods The HAMD-17 measuring scale was determined in 184 inpa-tients with type 2 diabetes from Fujian Provincial Hospital . A total of 106 patients with type 2 diabetes with depression were set as the case group (according with the depression of CCMD-3 diagnostic criteria , HAMD-17≥17 points) ,and 78 patients with type 2 diabetes without depression were set as the control group (HAMD-17≤7) . Glycosylated hemoglobin ,lipids ,C-reactive protein (CRP) ,and carotid intima-media thickness (IM T ) were performed in all patients . The risk factors associated with type 2 diabetes with depression ,and its relationship with inflammation and atherosclerosis was analyzed . Results (1) A higher BM I ,abdominal circumference ,incidence of diabetes microvascular complications and more female patients were found in type 2 diabetes with depression group . There are significant differences in treat-ment method between the two groups (P<0 .05) ,but no statistically significant differences in age and du-ration of diabetes between the two (P>0 .05) . (2) The levels of IM T ,CRP ,HbA1c in the case group were significantly higher than those in the control group (P<0 .05) ,while there were no statistically sig-nificant differences in lipids between the two groups (P>0 .05) . (3) In multiple linear regression analy-sis , the HAMD scores were positively correlated with IM T (Standard regression coefficient = 0 .234 , P<0 .05) and also positively correlated with HbA 1c(Standard regression coefficient=0 .348 , P<0 .01) , but no correlation was observed between HAMD scores and CRP (Standard regression coefficient=0 .030 , P>0 .05) . Conclusions Female ,obesity ,poor glycemic control ,microvascular complications and insu-lin therapy might all be the risk factors of type 2 diabetes with depression . Inflammation and atheroscle-rosis are related with the pathogenesis of depression in type 2 diabetes . Type 2 diabetes with depression is associated with both diabetic vascular disease and microvascular disease .
出处
《福建医科大学学报》
2013年第3期158-162,共5页
Journal of Fujian Medical University
关键词
糖尿病
2型
抑郁症
动脉硬化
危险因素
diabetes mellitus,type 2
depressive disorder
arteriosclerosis
risk factors
