老年期抑郁症患者抗抑郁药与胰岛素抵抗的相关性研究  

Effect of senile depression on insulin resistance

作　　者：戴志萍[1] 袁勇贵[1] 

机构地区：[1]南京医科大学脑科医院精神科, 南京210029

出　　处：《中国行为医学科学》2007年第10期889-891,共3页Chinese Journal of Behavioral Medical Science

基　　金：南京市医学科技发展项目（YKK0351）

摘　　要：目的探讨老年期抑郁症患者抗抑郁药与胰岛素抵抗的相关性。方法对57例老年期抑郁症患者（分为不伴糖尿病组47例,伴糖尿病组10例）和35名性别、年龄匹配的正常老年人,进行空腹血糖（FBG）、餐后2 h血糖（2HPG）、糖化血红蛋白（HbA1c）、空腹胰岛素浓度（FINS）测定。所有对象入组后测量体质量和身高,计算体质量指数（BMI）和胰岛素抵抗指数（HOMA-IR）。部分患者接受6周SSRI类抗抑郁药治疗后对相关指标进行复测。结果老年抑郁症患者,不论是否伴有糖尿病,FINS[（12.69±6.12）uIU/ml,（12.77±4.20）uIU/m l]和HOMA-IR[（2.65±1.40）,（3.94±1.06）]均显著低于正常对照组,而BM、IHbA1C与对照组相比差异无显著性。不伴糖尿病老年抑郁症（n=22）经SSRI类抗抑郁药治疗6周后,FINS和HOME-IR水平显著高于治疗前,但仍显著低于正常对照组。22例不伴糖尿病抑郁症患者治疗前HAMD评分与血清胰岛素浓度无显著相关性（r=0.055,P〉0.05）。结论老年期抑郁症患者存在胰岛功能紊乱,空腹胰岛素水平低下,胰岛素抵抗降低;抗抑郁剂治疗后胰岛功能有一定程度的改善;老年期抑郁症患者并发糖尿病时,应重视抗抑郁药的治疗。To study the effect of senile with depression and antidepressant drugs on insulin resistance. Methods 57 patients with senile depression were divided into group without diabetes mellitus （ n = 47 ） and group with diabetes mellitus （ n= 10） marched for sexual and age were selected as normal control group （ n = 35 ）. Three groups all were measured with fasting blood glucose （FPG） , 2-hour plasma glucose （2HPG） , glycated hemoglobinAl c （HbAlc） fasting insulin level（FINS） ,body mass and body height .Bodv mass index （BMI） and insulin resistance （HOMA-RI） were calculated. Some patients were measured again. Results FINS and HOMA-IR decreased significantly in senile depression groups both with and without diabetes mellitus compared with control group, but no significant differences were found for BMI and HbA1C. After six-week SSRI antidepressant drugs treatment, FINS and HOME-RI increased significantly in senile depression group without diabetes mellitus（ n= 22）, while below control group significantly. Our study was not demonstrated that score of HAMD in twenty-two patients without diabetes mellitus affect the level of FINS before the treatment significantly（ r=0. 055, P〉0.05）. Conclusion Senile depression has islet dysfunction, low level FINS, decreased HOMA-IR. Islet function may be improved after antidepressant drugs treatment. When senile depression combines with diabetes mellitus, it is necessary to pay attention to antidepressant drugs.

关 键 词：老年期抑郁症 抗抑郁药 胰岛素抵抗 糖尿病 

分 类 号：R686[医药卫生—骨科学]