2型糖尿病患者血清脂联素水平与其抑郁症状的影响因素分析

Association of serum adiponectin with depressive symptoms in T2DM patients

摘要:

目的  探讨2型糖尿病（T2DM）患者血清脂联素（APN）水平与其抑郁症状的相关性。方法  选取唐山市工人医院住院的T2DM患者523例作为研究对象。记录患者的年龄、性别、教育、体重指数（BMI）、病程。收集其临床检验结果，包括空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、同型半胱氨酸（Hcy）、超敏C反应蛋白（hs-CRP），酶联免疫吸附法（ELISA）法测定血清APN水平。用抑郁自评量表（SDS）对患者的抑郁症状进行评定，根据SDS评定结果将患者分为伴抑郁组和不伴抑郁组。结果  ①T2DM患者抑郁的患病率为36.7%，轻度抑郁患病率为27.5%，中度抑郁患病率为7.3%，重度抑郁患病率为1.9%；②与不伴抑郁组比较，伴抑郁组患者病程较长，BMI、HbA1c、TG、Hcy、hs-CRP水平较高，而APN水平较低（P <0.05）；③HDL（b=0.452，P =0.000）、TG（b=-0.036，P =0.018）、HbA1c（b=-0.114，P =
0.012）是APN的影响因素；④APN（b=-3.128，P =0.000）、Hcy（b=0.237，P =0.002）、病程（b=0.243，P =0.004）、HbA1c（b=0.645，P =0.018）是SDS评分的影响因素。结论  T2DM患者血清APN水平降低可能是其出现抑郁症状的危险因素之一。

Abstract:

Objective To investigate the association of serum adiponectin (APN) with depressive symptoms in T2DM patients. Methods Totally 523 patients with T2DM cared at Tangshan Gongren Hospital were recruited. Data including age, sex, education, duration of illness and BMI were recorded; and clinical parameters including FPG, HbA1c, TC, TG, LDL, HDL, Hcy and hsCRP were determined. APN was measured by ELISA. Depressive symptoms were assessed by the Self-rating Depression Scale (SDS), then T2DM patients were divided into two groups depending on the SDS scores which were T2DM with depressive symptoms group and without depressive symptoms group. Results The prevalence rate of depression in the male T2DM patients was 36.7%; the prevalence rate of mild, medium and heavy depression was 27.5%, 7.3% and 1.9% respectively. Compared with the T2DM patients without depressive symptoms, the duration of illness was longer, and the levels of BMI, HbA1c, TG, Hcy and hsCRP were higher in the patients with depressive symptoms ; however, the level of APN was lower (P < 0.05). HDL (b = 0.452, P = 0.000), TG (b = -0.036, P = 0.018) and HbA1c (b = -0.114, P = 0.012) were the influential factors for serum APN level. APN (b = -3.128, P = 0.000), Hcy (b = 0.237, P = 0.002), the duration of illness (b = 0.243, P = 0.004) and HbA1c (b = 0.645, P = 0.018) were the influential factors for SDS scores. Conclusions Decreased serum APN may be one of the risk factors for depressive symptoms in T2DM patients.