2型糖尿病患者焦虑和抑郁症状与认知测试及神经影像学之间的关联。
Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes.
作者信息
Raffield Laura M, Brenes Gretchen A, Cox Amanda J, Freedman Barry I, Hugenschmidt Christina E, Hsu Fang-Chi, Xu Jianzhao, Wagner Benjamin C, Williamson Jeff D, Maldjian Joseph A, Bowden Donald W
机构信息
Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Human Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
出版信息
J Diabetes Complications. 2016 Jan-Feb;30(1):143-9. doi: 10.1016/j.jdiacomp.2015.09.010. Epub 2015 Sep 25.
AIMS
Anxiety, depression, accelerated cognitive decline, and increased risk of dementia are observed in individuals with type 2 diabetes. Anxiety and depression may contribute to lower performance on cognitive tests and differences in neuroimaging observed in individuals with type 2 diabetes.
METHODS
These relationships were assessed in 655 European Americans with type 2 diabetes from 504 Diabetes Heart Study families. Participants completed cognitive testing, brain magnetic resonance imaging, the Brief Symptom Inventory Anxiety subscale, and the Center for Epidemiologic Studies Depression-10.
RESULTS
In analyses adjusted for age, sex, educational attainment, and use of psychotropic medications, individuals with comorbid anxiety and depression symptoms had lower performance on all cognitive testing measures assessed (p≤0.005). Those with both anxiety and depression also had increased white matter lesion volume (p=0.015), decreased gray matter cerebral blood flow (p=4.43×10(-6)), decreased gray matter volume (p=0.002), increased white and gray matter mean diffusivity (p≤0.001), and decreased white matter fractional anisotropy (p=7.79×10(-4)). These associations were somewhat attenuated upon further adjustment for health status related covariates.
CONCLUSIONS
Comorbid anxiety and depression symptoms were associated with cognitive performance and brain structure in a European American cohort with type 2 diabetes.
目的
在2型糖尿病患者中观察到焦虑、抑郁、认知衰退加速以及患痴呆症风险增加。焦虑和抑郁可能导致2型糖尿病患者在认知测试中的表现较差以及神经影像学上的差异。
方法
在来自504个糖尿病心脏研究家庭的655名患有2型糖尿病的欧裔美国人中评估了这些关系。参与者完成了认知测试、脑磁共振成像、简明症状量表焦虑分量表以及流行病学研究中心抑郁量表-10。
结果
在对年龄、性别、教育程度和精神药物使用进行校正的分析中，伴有焦虑和抑郁症状的个体在所有评估的认知测试指标上表现较差（p≤0.005）。同时患有焦虑和抑郁的个体还出现白质病变体积增加（p=0.015）、灰质脑血流量减少（p=4.43×10⁻⁶）、灰质体积减少（p=0.002）、白质和灰质平均扩散率增加（p≤0.001）以及白质分数各向异性降低（p=7.79×10⁻⁴）。在进一步对与健康状况相关的协变量进行校正后，这些关联有所减弱。
结论
在一个患有2型糖尿病的欧裔美国人队列中，共病的焦虑和抑郁症状与认知表现和脑结构相关。
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