利拉鲁肽对2型糖尿病患者焦虑、抑郁的影响  

Effect of liraglutide on anxiety and depression in patients with type 2 diabetes mellitus

作　　者：黄麟雁 陈克研[2] 向朝峰[3] 周岚 李思文 刘枝鑫 王丹[3] 段滨红[5] Huang Linyan;Chen Keyan;Xiang Chaofeng;Zhou Lan;Li Siwen;Liu Zhixin;Wang Dan;Duan Binhong(School of Clinical Medicine,Jiamusi University,Jiamusi 154007,China;Department of Endocrinology,First Affiliated Hospital of Jiamusi University,Jiamusi 154000,China;Department of Endocrinology,Heilongjiang Provincial Hospital,Harbin 150036,China;First Clinical College of Medicine,Mudanjiang Medical University,Mudanjiang 157011,China;Metabolic Management Center of Heilongjiang Provincial Hospital,Harbin 150036,China)

机构地区：[1]佳木斯大学临床医学院,佳木斯154007 [2]佳木斯大学附属第一医院内分泌科,佳木斯154000 [3]黑龙江省医院内分泌科,哈尔滨150036 [4]牡丹江医科大学第一临床医学院,牡丹江157011 [5]黑龙江省医院标准化代谢性疾病管理中心,哈尔滨150036

出　　处：《中华糖尿病杂志》2025年第2期227-234,共8页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的探讨利拉鲁肽对2型糖尿病(T2DM)患者焦虑、抑郁的影响。方法为随机对照试验。筛选自2023年1至6月于黑龙江省医院就诊的口服二甲双胍单药血糖控制不达标的门诊和住院的150例T2DM患者作为研究对象。将受试者以1∶1的比例按照随机数字表法分为利拉鲁肽治疗组和基础胰岛素治疗组,每组75例。两组均维持二甲双胍治疗剂量500 mg、3次/d口服,根据血糖值合理调整剂量,全部病例连续用药6个月。记录两组患者的年龄、性别、身高、体重、糖尿病家族史、吸烟及饮酒史、糖尿病病程等,计算体重指数(BMI)。在基线和治疗6个月后测量收缩压、舒张压,检测空腹血糖(FPG)、糖化血红蛋白(HbA1c)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α),评估患者用药前后的汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分。组间比较采用独立样本t检验或χ^(2)检验,组内比较采用配对t检验。采用Pearson相关分析法分析HAMA、HAMD与临床资料的相关性。采用二元logistic回归分析法分析治疗后焦虑和抑郁的危险因素。结果治疗6个月后,与基础胰岛素组相比,利拉鲁肽组T2DM患者的HAMA评分[分别为(4.39±1.26)和(5.72±1.43)分]、HAMD评分[分别为(4.71±2.13)和(5.61±2.30)分]、空腹血清IL-6[分别为(4.78±1.76)和(5.35±1.70)pg/ml]和TNF-α[分别为(12.44±2.54)和(13.58±2.94)pg/ml]均显著降低(P<0.05)。治疗6个月后患者的HAMA评分与治疗前后BMI、治疗后HbA1c、治疗前IL-6、治疗前HAMA评分、治疗后HAMD评分均呈正相关(r=0.319、0.232、0.294、0.246、0.563、0.250,均P<0.05)。Pearson相关分析结果显示,治疗6个月后患者的HAMD评分与病程、治疗前后HbA1c、治疗前后FPG、治疗前TNF-α、治疗前后HAMA评分以及治疗前HAMD评分均呈正相关(r=0.291、0.372、0.233、0.621、0.342、0.283、0.403、0.722、0.250,均P<0.05)。多因素logistic回归分析显示,病程、BMI、HbA1ObjectiveTo explore the effect of liraglutide on anxiety and depression in patients with type 2 diabetes mellitus(T2DM).MethodsThis study was a randomized controlled trial.A total of 150 outpatients and inpatients with T2DM who demonstrated substandard glycemic control on oral metformin monotherapy in Heilongjiang Provincial Hospital from January 2023 to June 2023 were enrolled as study subjects.They were divided into liraglutide-treated and basal insulin-treated groups in a 1∶1 ratio according to the random number method of sampling,there were 75 patients in each group.Both groups took metformin orally at a dose of 500 mg three times a day,adjusted according to the blood glucose values of patients for 6 months respectively.The age,sex,height,weight,family history of diabetes,smoking and drinking history,duration of diabetes within the two groups were recorded and the body mass index(BMI)was calculated.Systolic blood pressure,diastolic blood pressure,fasting plasma glucose(FPG),glycated hemoglobin A 1c(HbA 1c),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were measured at baseline and 6 months after treatment.In addition,the Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)of patients were assessed before and after medication.Independent samples t-test or chi-square test were used for intergroup comparisons,and paired t-test was used for intragroup comparisons.Then,Pearson correlation analysis was used to analyze the correlation between HAMA,HAMD,and clinical data.Binary logistic regression analysis was used to explore the risk factors for post-treatment anxiety and depression.ResultsAfter 6 months of treatment,compared to the basal insulin group,the HAMA scores[(4.39±1.26)and(5.72±1.43)points,respectively],HAMD scores[(4.71±2.13)and(5.61±2.30)points,respectively],fasting serum IL-6[(4.78±1.76)and(5.35±1.70)pg/ml,respectively]and TNF-α[(12.44±2.54)and(13.58±2.94)pg/ml,respectively]of the liraglutide group were significantly reduced(all P<0.05).Pearson analysis revealed that,at t

关 键 词：糖尿病 2型 焦虑 抑郁 利拉鲁肽 基础胰岛素 

分 类 号：R587.1[医药卫生—内分泌]