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代谢综合征患者抑郁症状与认知障碍之间的关联。

Association between depressive symptoms and cognitive impairment in patients with metabolic syndrome.

作者信息

Kopchak Oksana, Pulyk Oleksander

机构信息

Private Higher Education Establishment "Kyiv Medical University" Kyiv, Ukraine.

The State Institution Of Higher Education "Uzhhorod Nationally University" Uzhhorod, Ukraine.

出版信息

Wiad Lek. 2017;70(4):737-741.

Abstract

INTRODUCTION

Metabolic dysregulation is intimately associated with wide array of seemingly unrelated disorders, including cognitive impairment and depression. The aim was: to identify special characteristic features of depressive disorder in patients with metabolic syndrome (Mets); to identify possible association between depressive disorder (DD) and cognitive impairment in patients with Mets; to establish whether metabolic syndrome and its components are associated with severity of DD.

MATERIALS AND METHODS

The study group consisted of 108 patients with depressive disorders aged from 45 to 84 years. All patients were divided into two groups: main- with Mets (n=60) and control - without metabolic syndrome (n=48), comparable for age, sex and level of education. The examination consisted of physical and neurological examination and the application of neuropsychological tests (Mini-Mental State Examination/MMSE, Hamilton Depression Rating Scale / HAM-D) magnetic resonance imaging and laboratory tests.

RESULTS

It has been found more pronounced severity of depressive disorder (DD) in patients with Mets compared with patients without it (p<0,05). In the group of patients with Mets there was significantly higher incidence of somatic anxiety (p <0,01), hypochondria (p <0,05), reduced criticality (p <0,05) compared with patients without Mets. It has been found significantly higher incidence of dementia in patients with DD and Mets comparing with patients with DD without Mets (p<0,05). Statistically significant negative correlation was found between the total score on the Hamilton scale and the total MMSE score (r = -0,56, p <0.05) only in the group of patients with Mets. Of all Mets components a reliable positive correlation was found only between high triglyceride levels of blood and the total Hamilton scale score (rs = 0,27).

CONCLUSIONS

Our study adds to the mounting evidence that links depression and Mets. Some specific features of DD in patients with MetS were established. The severity of DD was significantly associated with severity of cognitive impairment in patients with Mets. Of all components of Mets, only elevated levels of triglycerides of blood was significantly associated with the severity of DD in our maim group of patients.

摘要

引言

代谢失调与一系列看似不相关的疾病密切相关,包括认知障碍和抑郁症。目的是:确定代谢综合征(Mets)患者抑郁症的特殊特征;确定抑郁症(DD)与Mets患者认知障碍之间的可能关联;确定代谢综合征及其组成部分是否与DD的严重程度相关。

材料与方法

研究组由108例年龄在45至84岁之间的抑郁症患者组成。所有患者分为两组:主要组——患有Mets(n = 60),对照组——无代谢综合征(n = 48),两组在年龄、性别和教育水平方面具有可比性。检查包括体格检查和神经学检查,以及应用神经心理学测试(简易精神状态检查表/MMSE、汉密尔顿抑郁量表/HAM-D)、磁共振成像和实验室检查。

结果

已发现患有Mets的患者与未患Mets的患者相比,抑郁症(DD)的严重程度更为明显(p<0.05)。与未患Mets的患者相比,Mets患者组中躯体焦虑(p <0.01)、疑病症(p <0.05)、批判性降低(p <0.05)的发生率显著更高。已发现患有DD和Mets的患者与未患Mets的DD患者相比,痴呆症的发生率显著更高(p<0.05)。仅在Mets患者组中,汉密尔顿量表总分与MMSE总分之间存在统计学上显著的负相关(r = -0.56,p <0.05)。在所有Mets组成部分中,仅发现血液中高甘油三酯水平与汉密尔顿量表总分之间存在可靠的正相关(rs = 0.27)。

结论

我们的研究进一步证明了抑郁症与Mets之间的联系。确定了Mets患者中DD的一些特定特征。DD的严重程度与Mets患者认知障碍的严重程度显著相关。在Mets的所有组成部分中,在我们的主要患者组中,仅血液中甘油三酯水平升高与DD的严重程度显著相关。

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