住院2型糖尿病患者合并抑郁症的相关危险因素分析  

Analysis of associated risk factors for depression in hospitalized patients with type 2 diabetes

作　　者：赵倩 孟祥英 陈建杨 刘丛 史小燕 王奕 ZHAO Qian;MENG Xiangying;CHEN Jianyang;LIU Cong;SHI Xiaoyan;WANG Yi(Department of Endocrinology,Dahua Hospital,Xuhui District,Shanghai,200237,China)

机构地区：[1]上海市徐汇区大华医院内分泌科,上海200237

出　　处：《当代医学》2025年第1期62-68,共7页Contemporary Medicine

基　　金：上海市徐汇区科委项目(SHXH202047);上海市徐汇区科委项目(SHXH202208)。

摘　　要：目的分析住院2型糖尿病(type 2 diabetes mellitus,T2DM)患者合并抑郁症的危险因素,提高临床对抑郁症早期识别能力,并及时采取针对性干预措施,提高糖尿病的综合管理水平。方法选取2020年7月至2022年12月于上海市徐汇区大华医院内分泌科住院的261例T2DM患者作为研究对象,其中T2DM无抑郁症患者176例,T2DM合并抑郁症患者85例。采用流行病学问卷调查患者的临床资料,所有患者行实验室检查,采用多因素Logistic回归模型分析T2DM合并抑郁症的危险因素。结果T2DM合并抑郁症患者年龄、血糖自我监测频率及低血糖发生频率评分均高于T2DM无抑郁症患者,糖尿病病程长于T2DM无抑郁症患者,家庭平均收入、糖尿病认知评分、运动评分、舒张压均低于T2DM无抑郁症患者,差异有统计学意义(P<0.05)。T2DM合并抑郁症患者空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白A1c、单胺氧化酶、同型半胱氨酸(homocysteine,Hcy)、促甲状腺素激素、白细胞介素-6水平均高于T2DM无抑郁症患者,谷丙转氨酶,胆碱酯酶、岩藻糖苷酶、磷、镁(magnesium,Mg)、游离三碘甲状腺原氨酸水平均低于T2DM无抑郁症患者,差异有统计学意义(P<0.05)。多因素Logistic回归模型分析结果显示,血糖自我监测频率评分高、低血糖发生频率评分高、糖尿病病程长、FBG水平高、Hcy水平高是T2DM合并抑郁症的危险因素(P<0.05),糖尿病认知评分高、Mg水平高是T2DM合并抑郁症的保护因素(P<0.05)。结论T2DM合并抑郁症的危险因素较复杂,临床尤其应提高T2DM患者对糖尿病的认知,积极控制血糖,减少低血糖的发生,合理监测血糖,降低血清Hcy水平,适当补充Mg制剂,可能对降低T2DM患者发生抑郁风险及改善抑郁症状具有一定的意义。Objective To analyze the risk factors of depression in hospitalized patients with type 2 diabetes mellitus(T2DM)to improve the ability of early clinical identification of depression,and take timely targeted intervention measures to improve the comprehensive management level of diabetes.Methods 261 T2DM patients admitted to the department of Endocrinology in Dahua Hospital,Xuhui District,Shanghai from July 2020 to December 2022 were selected as the study subjects,including 176 T2DM patients without depression and 85 T2DM patients with depression.The clinical data of the patients were investigated by epidemiological questionnaire,laboratory indicators were detected,and the risk factors of T2DM combined with depression were analyzed by multivariate Logistic regression model.Results The age,frequency of self-monitoring of blood glucose and frequency of hypoglycemia of T2DM patients with depression were higher than those of T2DM patients without depression,the duration of diabetes was longer than that of T2DM patients without depression,and the average family income,cognition of diabetes,exercise frequency and diastolic blood pressure were lower than those of T2DM patients without depression,the differences were statistically significant(P<0.05).The levels of fasting blood glucose(FBG),hemoglobin A1c,monoamine oxidase,homocysteine(Hcy),thyroid stimulating hormone and interleukin 6 of T2DM patients with depression were higher than those of T2DM patients without depression,and the levels of glutamic pyruvic transaminase,cholinesterase,hydroxybutyric dehydrogenase,phosphorus,magnesium(Mg),free triiodothyronine were lower than those of T2DM patients without depression,and the differences were statistically significant(P<0.05).Multivariate Logistic regression model analysis showed that high frequency self-monitoring of blood glucose score,high frequency of hypoglycemia score,long course of diabetes,high FBG level,high Hcy level were risk factors for T2DM combined with depression(P<0.05),high cognitive score and Mg level we

关 键 词：2型糖尿病 抑郁症 危险因素 

分 类 号：R587.1[医药卫生—内分泌]