Selenius Jannica S, Wasenius Niko S, Kautiainen Hannu, Salonen Minna, von Bonsdorff Mikaela, Eriksson Johan G
Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
Public Health Research Porgramme, Folkhälsan Research Center, Helsinki, Finland.
BMJ Open Diabetes Res Care. 2020 Oct;8(1). doi: 10.1136/bmjdrc-2020-001568.
This study aims to investigate whether the associations between impaired glucose regulation and health-related quality of life are modified by severity or type of depressive symptoms.
For this cross-sectional study, we included 1939 individuals (mean age 61.5 years) from the Helsinki Birth Cohort Study. Between 2001 and 2004, a standard 2-hour 75 g oral glucose tolerance test was applied to define normoglycemia, pre-diabetes, and newly diagnosed diabetes. Information on previously diagnosed diabetes was collected from national registers and questionnaires. Pre-diabetes was defined as having either impaired fasting glucose or impaired glucose tolerance. The Mental and Physical Component Scores of health-related quality of life were assessed with Short Form-36. Beck's Depression Inventory was employed to investigate the severity of depressive symptoms and to define minimal (depression score <10), non-melancholic, and melancholic types of depression. We analyzed data with general linear models adjusted for sex, age, lifestyle factors, comorbidities, and body mass index.
Glucose regulation subgroups, especially previously known diabetes, were associated with lower Physical Component Score (p=0.001) and higher depression score (p=0.015), but not with the Mental Component Score (p=0.189). Non-melancholic depression was associated with lower Physical and Mental Component Scores compared with those with depression score <10 and melancholic depression (p<0.001), independently of glucose regulation status (p for glucose regulation status by depression type interaction >0.54).
Non-melancholic type of depression and previously known diabetes are independently associated with lower health-related quality of life. This should be appraised in long-term treatment of diabetes and when treating non-melancholic depressive symptoms to maintain a higher health-related quality of life.
本研究旨在调查血糖调节受损与健康相关生活质量之间的关联是否会因抑郁症状的严重程度或类型而有所改变。
在这项横断面研究中，我们纳入了赫尔辛基出生队列研究中的1939名个体（平均年龄61.5岁）。在2001年至2004年期间，采用标准的2小时75克口服葡萄糖耐量试验来定义血糖正常、糖尿病前期和新诊断的糖尿病。从国家登记处和问卷中收集先前诊断糖尿病的信息。糖尿病前期定义为空腹血糖受损或葡萄糖耐量受损。使用简短健康调查问卷-36评估健康相关生活质量的心理和生理成分得分。采用贝克抑郁量表来调查抑郁症状的严重程度，并定义轻度（抑郁评分<10）、非忧郁型和忧郁型抑郁症。我们使用针对性别、年龄、生活方式因素、合并症和体重指数进行调整的一般线性模型分析数据。
血糖调节亚组，尤其是先前已知的糖尿病患者，与较低的生理成分得分（p=0.001）和较高的抑郁评分（p=0.015）相关，但与心理成分得分无关（p=0.189）。与抑郁评分<10的患者和忧郁型抑郁症患者相比，非忧郁型抑郁症患者的生理和心理成分得分较低（p<0.001），且与血糖调节状态无关（抑郁类型与血糖调节状态的交互作用p>0.54）。
非忧郁型抑郁症和先前已知的糖尿病分别与较低的健康相关生活质量相关。在糖尿病的长期治疗以及治疗非忧郁型抑郁症状时，应考虑到这一点，以维持较高的健康相关生活质量。
