Micozkadioglu Hasan, Micozkadioglu Irem, Zumrutdal Aysegul, Erdem Abdullah, Ozdemir Fatma Nurhan, Sezer Siren, Haberal Mehmet
Department of Nephrology, Başkent University Faculty of Medicine, Hospital of Adana, Adana, Turkey.
Nephrology (Carlton). 2006 Dec;11(6):502-5. doi: 10.1111/j.1440-1797.2006.00664.x.
Depression is associated with high mortality in haemodialysis (HD) patients, and can be associated with the poor oral intake that contributes to malnutrition. Malnutrition-inflammation complex syndrome (MICS) causes increased morbidity and mortality in HD patients. We investigated relationships between depressive affect, social support and various components of MICS in HD patients.
The subjects were 110 patients (65 men and 45 women, mean age 45.39 +/- 14.73 years) on maintenance HD. The Beck Depression Inventory (BDI), Cognitive Depression Index (CDI), and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess aspects of depressive affect in each subject.
The mean dialysis duration was 53.04 +/- 38.15 months. The mean BDI and CDI scores were 12.10 +/- 7.43 and 8.40 +/- 5.72, respectively. Patients were divided into two subgroups according to CDI score (depressive affect >10 (n = 71) and non-depressive affect <or=10 (n = 39)). CDI score was correlated with malnutrition-inflammation score (MIS) (r = 0.24; P < 0.05), haemoglobin level (r = -0.23; P < 0.05) and MSPSS score (r = -0.28; P < 0.01). The subgroup with depressive affect had higher MIS (P < 0.01) and lower social support (P = 0.001) than the non-depressive affect group. Logistic regression analysis identified high MIS and low MSPSS score as independent risk factor for depression.
The results suggest that MIS and MSPSS are the strongest predictors of depressive affect in HD patients. Further research is needed to understand the causal relationship between depressive affect and MICS in HD patients.
抑郁症与血液透析（HD）患者的高死亡率相关，并且可能与导致营养不良的口服摄入量低有关。营养不良-炎症复合综合征（MICS）会增加HD患者的发病率和死亡率。我们调查了HD患者中抑郁情绪、社会支持与MICS各组成部分之间的关系。
研究对象为110例维持性HD患者（65例男性和45例女性，平均年龄45.39±14.73岁）。使用贝克抑郁量表（BDI）、认知抑郁指数（CDI）和领悟社会支持多维量表（MSPSS）评估每个受试者的抑郁情绪方面。
平均透析时间为53.04±38.15个月。BDI和CDI的平均得分分别为12.10±7.43和8.40±5.72。根据CDI得分将患者分为两个亚组（抑郁情绪>10（n = 71）和非抑郁情绪≤10（n = 39））。CDI得分与营养不良-炎症评分（MIS）（r = 0.24；P < 0.05）、血红蛋白水平（r = -0.23；P < 0.05）和MSPSS得分（r = -0.28；P < 0.01）相关。与非抑郁情绪组相比，抑郁情绪亚组的MIS更高（P < 0.01），社会支持更低（P = 0.001）。逻辑回归分析确定高MIS和低MSPSS得分是抑郁的独立危险因素。
结果表明，MIS和MSPSS是HD患者抑郁情绪的最强预测因素。需要进一步研究以了解HD患者抑郁情绪与MICS之间的因果关系。
