中老年2型糖尿病患者血清25羟基维生素D水平及其与睡眠质量和焦虑抑郁状态的相关性研究  

Study on relationship of serum 25-hydroxy vitamin D level with sleep duration,anxiety and depression in middleaged and elderly patients with type 2 diabetes mellitus

作　　者：王晓妍[1] 张天昊 Wang Xiaoyan;Zhang Tianhao(Department of Endocrinology,Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院内分泌三科,071000 [2]保定市第一中心医院普通外二科,071000

出　　处：《北京医学》2024年第12期1057-1063,共7页Beijing Medical Journal

基　　金：保定市科技计划(2241ZF061)。

摘　　要：目的探讨中老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清25羟基维生素D[25-hydroxy vitamin D,25(OH)D]水平变化及其与睡眠质量和焦虑抑郁状态的相关性。方法选取2020年12月至2021年12月保定市第一中心医院中老年T2DM患者300例,并选择同期我院300名健康体检者作为健康对照,比较两组患者血清25(OH)D水平、匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)评分、汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)评分及24项汉密尔顿抑郁量表(hamilton depression scale-24,HAMD-24)评分。采用Pearson相关性分析T2DM患者血清25(OH)D水平与PSQI评分、HAMA评分及HAMD-24评分的相关性;采用多因素logistic回归分析T2DM患者发生睡眠质量差、焦虑抑郁状态的影响因素。结果300例T2DM患者中,男157例,女143例,年龄40~80岁,平均(56.6±11.0)岁。T2DM组血清25(OH)D水平低于健康对照组,PSQI、HAMA、HAMD-24评分高于健康对照组,差异均有统计学意义(P<0.05)。T2DM患者血清25(OH)D水平与PSQI、HAMA、HAMD-24评分均呈负相关(P<0.05)。多因素logistic回归分析结果显示,HbA1c越高(OR=1.652,95%CI:1.183~6.372,P<0.001)、血清25(OH)D越低(OR=0.816,95%CI:0.724~0.937,P<0.001)、HAMA评分越高(OR=2.347,95%CI:1.365~5.582,P<0.001)、HAMD-24评分越高(OR=2.285,95%CI:1.286~5.987,P<0.001)的T2DM患者发生睡眠质量越差的风险越高;病程越长(OR=2.172,95%CI:1.194~6.824,P<0.001)、HbA1c越高(OR=1.963,95%CI:1.172~6.193,P<0.001)、血清25(OH)D越低(OR=0.762,95%CI:0.665~0.892,P<0.001)、PSQI评分越高(OR=1.876,95%CI:1.165~7.276,P<0.001)的T2DM患者发生焦虑抑郁的风险越高。结论T2DM患者血清25(OH)D水平较低,且与患者睡眠质量、焦虑抑郁状态呈负相关,是T2DM患者出现睡眠质量差、焦虑抑郁状态的影响因素。Objective To explore the changes of serum 25 hydroxyvitamin D[25(OH)D]level and its relationship with sleep quality,anxiety and depression in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 300 T2DM patients in Baoding First Central Hospital from December 2020 to December 2021 were selected,and 300 healthy physical examination subjects who underwent physical examination in the hospital during the same period were selected as the healthy control group.The serum 25(OH)D level,pittsburgh sleep quality index(PSQI)score,hamilton anxiety scale(HAMA)score and hamilton depression scale-24(HAMD-24)score were compared between the two groups.The correlation between serum 25(OH)D level and PSQI score was analyzed by Pearson test,and the influencing factors of poor sleep quality,anxiety and depression in T2DM patients were analyzed by multivariate logistic regression.Results Among the 300 T2DM patients,there were 157 males and 143 females,aged from 40 to 80 years,with an average of(56.6±11.0)years.The level of serum 25(OH)D in T2DM group was lower than that in healthy control group,and the scores of PSQI,HAMA and HAMD-24 were higher than those in healthy control group,and the differences were statistically significant(P<0.05).Serum 25(OH)D levels in T2DM patients were negatively correlated with the scores of PSQI,HAMA and HAMD-24(P<0.05).Multivariate logistic regression analysis showed that T2DM patients with higher HbA1c(OR=1.652,95%CI:1.183-6.372,P<0.001),lower serum 25(OH)D(OR=0.816,95%CI:0.724-0.937,P<0.001),higher HAMA score(OR=2.347,95%CI:1.365-5.582,P<0.001)and higher HAMD-24 score(OR=2.285,95%CI:1.286-5.987,P<0.001)had higher risk of worse sleep quality.T2DM patients with longer course of disease(OR=2.172,95%CI:1.194-6.824,P<0.001),higher HbA1c(OR=1.963,95%CI:1.172-6.193,P<0.001),lower serum 25(OH)D(OR=0.762,95%CI:0.665-0.892,P<0.001),and higher PSQI score(OR=1.876,95%CI:1.165-7.276,P<0.001)had higher risk of anxiety and depression.Conclusions The level of serum 25(OH)D in T2DM

关 键 词：2型糖尿病 25羟基维生素D 睡眠质量 焦虑 抑郁 中老年 

分 类 号：R58[医药卫生—内分泌]