Jiao Jian-Tong, Jiang Chen, Huang Jin, Dai Min-Chao, Wang Cheng, Cheng Chao, Shao Jun-Fei
Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China.
Med Oncol. 2014 Oct;31(10):234. doi: 10.1007/s12032-014-0234-y. Epub 2014 Sep 16.
To date, the relationship between metabolic syndrome factors and the risk of glioma-related depression is still unclear, and no study investigates this relationship. Our aim was to investigate the relationship between metabolic syndrome factors and the risk of postoperative depression in high-grade patients. A total of 386 high-grade glioma patients participated in blood sample collection for metabolic syndrome factors analysis and the hospital anxiety and depression scale testing. The association between metabolic syndrome factors and the risk of postoperative depression was assessed using Cox regression proportional hazards models, and Student's t tests were used to evaluate the differences in demographic variables and clinical characteristics in subgroups. The incidence of postoperative depression in our 1.5-year follow-up was 30.5%. We found the risk of postoperative depression was elevated with increased blood glucose level [hazard ratios (HR) 2.277, 95% confidence interval (CI) 1.201-4.320, top vs. bottom quartile]. The hazard ratio was increased for z-scores of blood glucose (HR 1.672 per unit standard deviation, 95% CI 1.311-2.133] and of the combined metabolic syndrome score (HR 1.080, 95% CI 1.000-1.167). In addition, risk of postoperative depression risk was increased in high-grade glioma patients with high blood glucose levels (≥6.0 mmol/l) (HR 2.084, 95% CI 1.235-3.515). However, we did not find significant associations between postoperative depression and other metabolic syndrome factors, including body mass index, systolic blood pressure, diastolic blood pressure, cholesterol, and triglycerides. Depression is prevalent among patients with high-grade glioma after operation. Blood glucose level is positively associated with the risk of postoperative depression, and might be involved in the etiology of postoperative depression, and may predict its development in high-grade glioma patients.
迄今为止，代谢综合征因素与胶质瘤相关性抑郁风险之间的关系仍不明确，尚无研究对这种关系进行调查。我们的目的是研究代谢综合征因素与高级别胶质瘤患者术后抑郁风险之间的关系。共有386例高级别胶质瘤患者参与了代谢综合征因素分析的血样采集及医院焦虑抑郁量表测试。使用Cox回归比例风险模型评估代谢综合征因素与术后抑郁风险之间的关联，并采用Student's t检验评估亚组中人口统计学变量和临床特征的差异。我们1.5年随访期间术后抑郁的发生率为30.5%。我们发现，随着血糖水平升高，术后抑郁风险升高[风险比（HR）2.277，95%置信区间（CI）1.201 - 4.320，最高四分位数与最低四分位数相比]。血糖z评分（每单位标准差HR 1.672，95% CI 1.311 - 2.133）和综合代谢综合征评分（HR 1.080，95% CI 1.000 - 1.167）的风险比也升高。此外，血糖水平高（≥6.0 mmol/l）的高级别胶质瘤患者术后抑郁风险增加（HR 2.084，95% CI 1.235 - 3.515）。然而，我们未发现术后抑郁与其他代谢综合征因素之间存在显著关联，包括体重指数、收缩压、舒张压、胆固醇和甘油三酯。抑郁在高级别胶质瘤术后患者中普遍存在。血糖水平与术后抑郁风险呈正相关，可能参与了术后抑郁的病因，并且可能预测高级别胶质瘤患者术后抑郁的发生。
