Behavioral Medicine Research Center, University of Miami, Miami, FL, USA; Department of Psychology, University of Miami, Miami, FL, USA.
Diabet Med. 2014 May;31(5):630-6. doi: 10.1111/dme.12356. Epub 2013 Dec 18.
The addition of the 1-h plasma glucose concentration measure from an oral glucose tolerance test to prediction models of future Type 2 diabetes has shown to significantly strengthen their predictive power. The present study examined the relationship between severity of depressive symptoms and hyperglycaemia, focusing on the 1-h glucose concentration vs. fasting and 2-h glucose measures from the oral glucose tolerance test.
Participants included 140 adults with the metabolic syndrome and without diabetes who completed a baseline psychobiological assessment and a 2-h oral glucose tolerance test, with measurements taken every 30 min. Depressive symptoms were assessed using the Beck Depression Inventory.
Multivariate linear regression revealed that higher levels of depressive symptoms were associated with higher levels of 1-h plasma glucose concentrations after adjusting for age, gender, ethnicity, BMI, antidepressant use and high-sensitivity C-reactive protein. Results were maintained after controlling for fasting glucose as well as for indices of insulin resistance and secretion. Neither fasting nor 2-h plasma glucose concentrations were significantly associated with depressive symptoms.
Elevated depressive symptoms in persons with the metabolic syndrome were associated with greater glycaemic excursion 1-h following a glucose load that was not accounted for by differences in insulin secretory function or insulin sensitivity. Consistent with previous findings, this study highlights the value of the 1-h plasma glucose measurement from the oral glucose tolerance test in the relation between depressive symptoms and glucose metabolism as an indicator of metabolic abnormalities not visible when focusing on fasting and 2-h post-oral glucose tolerance test measurements alone.
在预测 2 型糖尿病未来发生的模型中加入口服葡萄糖耐量试验的 1 小时血浆葡萄糖浓度测量值，显著增强了其预测能力。本研究检查了抑郁症状严重程度与高血糖之间的关系，重点关注口服葡萄糖耐量试验的 1 小时血糖浓度与空腹和 2 小时血糖测量值。
参与者包括 140 名患有代谢综合征且无糖尿病的成年人，他们完成了基线心理生物学评估和 2 小时口服葡萄糖耐量试验，每隔 30 分钟进行一次测量。使用贝克抑郁量表评估抑郁症状。
多元线性回归显示，在调整年龄、性别、种族、BMI、抗抑郁药使用和高敏 C 反应蛋白后，抑郁症状越严重，1 小时血浆葡萄糖浓度越高。在控制空腹血糖以及胰岛素抵抗和分泌指数后，结果仍然成立。空腹和 2 小时血浆葡萄糖浓度与抑郁症状均无显著相关性。
代谢综合征患者的抑郁症状升高与葡萄糖负荷后 1 小时血糖水平升高有关，而这种升高不能用胰岛素分泌功能或胰岛素敏感性的差异来解释。与之前的研究结果一致，本研究强调了口服葡萄糖耐量试验的 1 小时血浆葡萄糖测量值在抑郁症状与葡萄糖代谢之间的关系中的价值，作为仅关注空腹和口服葡萄糖耐量试验后 2 小时测量值时不可见的代谢异常的指标。
