FPG、TG、HDL-C与双相情感障碍患者预后的相关性分析  

Correlation analysis of FPG,TG,HDL-C andprognosis in patients with bipolar disorder

作　　者：胡孝芬 杨善杰[2] 欧阳泽祥 韩友松 金晶 HU Xiaofen;YANG Shanjie;OUYANG Zexiang;HAN Yousong;JIN Jing(Department of Clinical Psychology,the Sixth People’s Hospital of Anqing,Anqing Anhui 246003,China;Department of Psychiatry,the Sixth People’s Hospital of Anqing,Anqing Anhui 246003,China)

机构地区：[1]安徽省安庆市第六人民医院临床心理科,安徽安庆246003 [2]安徽省安庆市第六人民医院精神科,安徽安庆246003

出　　处：《新疆医科大学学报》2022年第10期1168-1173,共6页Journal of Xinjiang Medical University

基　　金：2021年度安徽省转化医学研究院科技基金项目(2021zhyx-C29)。

摘　　要：目的分析空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白(HDL-C)与双相情感障碍(BPD)患者预后的相关性。方法选取2017年8月-2019年8月安徽省安庆市第六人民医院接诊的BPD患者110例,治疗24周后随访12个月,根据预后情况将其分为良好组、不良组。比较良好组、不良组FPG、TG、HDL-C及其他预后可能影响因素的差异;Cox回归分析法分析BPD预后的影响因素;绘制受试者工作曲线(ROC),分析FPG、TG、HDL-C单独及联合预测BPD预后不良的效能;以ROC最佳截断点分组,采用Kaplan-Meier法分析不同FPG、TG、HDL-C水平患者预后情况。结果随访12个月共12例患者失访,98例获得随访。98例患者中66例预后良好,设置为良好组,其余32例设置为不良组。不良组家庭负担调查表(FEIS)评分、HDL-C低于良好组,服药依从性差占比、腰围(WC)、体质量指数(BMI)、收缩压(SBP)、FPG、TG高于良好组(P<0.05);Cox回归分析显示,FPG、TG高,服药依从性差,FEIS评分、HDL-C低是影响BPD预后的独立危险因素(P<0.05);ROC结果显示,FPG、TG、HDL-C预测BPD预后不良的最佳截断点分别为6.01 mmol/L、1.72 mmol/L、1.26 mmol/L,三者单独及联合预测BPD预后不良的AUC分别为0.636、0.752、0.827、0.848。Kaplan-Meier法分析结果显示,FPG>6.01 mmol/L与FPG<6.01 mmol/L,TG>1.72 mmol/L与TG<1.72 mmol/L,HDL-C<1.26 mmol/L与HDL-C>1.26 mmol/L患者的预后曲线比较,差异均有统计学意义(P<0.001)。结论BPD预后不良患者FPG、TG异常升高,HDL-C异常降低,FPG、TG、HDL-C与预后关系密切,且三者单独及联合检测可作为预测BPD预后的重要参考指标。Objective To analyze the correlation between fasting blood glucose(FPG),triglycerides(TG),high-density lipoprotein(HDL-C)and the prognosis in patients with bipolar disorder(BPD).Methods A total of 110 BPD patients admitted to the hospital from August 2017 to August 2019 were selected and followed up for 12 months after 24 weeks of the treatment.The patients were divided into the good group and the poor group according to the prognosis.The differences in FPG,TG,HDL-C and the other prognostic factors that may affect the prognosis of the good group and the poor group were compared.The factors affecting the prognosis of BPD were analyzed byCoxregression analysis.The receiver operating curve(ROC)was drawn to analyze the efficacy of FPG,TG,HDL-C alone and in combination for predicting poor prognosis of BPD.The patients were grouped by the best cut-off point of ROC,and the prognosis of the patients with different levels of FPG,TG and HDL-C were analyzed byKaplan-Meier method.ResultsThe follow-up period was 12 months,12 patients were lost to follow-up,and 98 patients were still followed up.66 of the 98 patients had a good prognosis and were set as the good group,and the remaining 32 patients were set as the poor group.The family experience interview schedule(FEIS)score and HDL-C of the poor group were lower than those of the good group,while the proportion of poor medication compliance,waist circumference(WC),body mass index(BMI),systolic blood pressure(SBP),FPG,and TG in the poor group were higher than those of the good group(P<0.05).Coxregression analysis showed that high FPG and TG,poor medication compliance,low FEIS score and HDL-C level were risk factors affecting the prognosis of BPD(P<0.05).ROCresults showed that the best cut-off points for FPG,TG,and HDL-C to predict poor efficacy of BPD lamotrigine were6.01 mmol/L,1.72 mmol/L,and 1.26 mmol/L.The AUCs of the three alone and in combination predicting poor prognosis of BPD were 0.636,0.752,0.827,and 0.848,respectively.The results ofKaplan-Meieranalysis showed that

关 键 词：双相情感障碍 空腹血糖 甘油三酯 高密度脂蛋白 

分 类 号：R749.4[医药卫生—神经病学与精神病学]