Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
J Evid Based Med. 2019 Feb;12(1):51-55. doi: 10.1111/jebm.12224. Epub 2019 Feb 6.
To investigate the prevalence of impaired glucose regulation (IGR) in patients with anxiety disorders and the relationship with hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axes function.
From September 2013 to May 2015, a total of 646 patients with anxiety disorders who matched the criteria of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems participated in our study, which was conducted in the Psychiatric Inpatient Department of the West China Hospital of Sichuan University. The results from 75-g glucose tolerance tests, and morning (8:00 am) serum cortisol (PTC), adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), TT3, TT4, FT3, and FT4 levels were collected. The Hamilton Anxiety Scale was administered to assess the severity of anxiety. SPSS 17.0 software was used for statistical analysis.
The crude prevalence of impaired glucose regulation was 24.61% in patients with anxiety disorders patients. In the 18- to 40-year age group with impaired glucose regulation (IGR), both ACTH and PTC levels were higher than the control group (P < 0.05). In the 61- to 75-year age group with IGR, the TSH level was lower and the FT4 level was higher than the control group (P < 0.05).
The results herein partially confirm that the prevalence of IGR in patients with anxiety disorders is high. Impaired glucose in the younger age group is closely associated with HPA axis function, while impaired glucose in the older age group is closely associated with HPT axis alteration. Therefore, routine blood glucose and endocrine function testing in patients with anxiety disorder is of clinical importance to prevent the development of diabetes.
探讨焦虑障碍患者糖调节受损(IGR)的患病率及其与下丘脑-垂体-肾上腺(HPA)和下丘脑-垂体-甲状腺(HPT)轴功能的关系。
本研究于 2013 年 9 月至 2015 年 5 月选取符合《国际疾病分类第 10 次修订本(ICD-10)》焦虑障碍诊断标准的 646 例患者,均为四川大学华西医院心理卫生中心住院患者。采集患者 75g 葡萄糖耐量试验结果及清晨(8:00 时)血清皮质醇(PTC)、促肾上腺皮质激素(ACTH)、促甲状腺激素(TSH)、三碘甲状腺原氨酸(TT3)、甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平,采用 Hamilton 焦虑量表评估患者焦虑严重程度。采用 SPSS 17.0 软件进行统计学分析。
焦虑障碍患者糖调节受损的粗患病率为 24.61%。在年龄 1840 岁糖调节受损组中,ACTH 和 PTC 水平均高于对照组(P<0.05);在年龄 6175 岁糖调节受损组中,TSH 水平低于对照组,FT4 水平高于对照组(P<0.05)。
本研究结果部分证实了焦虑障碍患者中 IGR 的患病率较高。年轻患者的糖调节受损与 HPA 轴功能密切相关,而老年患者的糖调节受损与 HPT 轴改变密切相关。因此,焦虑障碍患者常规进行血糖和内分泌功能检查具有重要的临床意义,可预防糖尿病的发生。