Dong Guan-Zhong, Zhang Qiao-Yang, Jiao Yu-Wen, Ma Yi, Zhu Shu-Min, Zhang Li-Hao, Zhang Min, Chen Yun, Ye Xin-Hua, Cao Yin, Tang Li-Ming
Department of Psychology, the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
Department of Gastrointestinal Surgery, the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
Ann Transl Med. 2022 Feb;10(3):134. doi: 10.21037/atm-22-192.
To explore the contribution of type 2 diabetes mellitus (T2DM) to hypothalamic inflammation and depressive disorders in young patients with obesity.
According to the diagnostic criteria for T2DM, all of patients with obesity were divided into the diabetic and the non-diabetic groups. The severity of depressive disorders was assessed by self-rating depression scale (SDS). The signal intensity (SI) ratio of the T2-weighted phase of the superior hypothalamus/amygdala (H/A) was measured using a quantitative magnetic resonance imaging (MRI) technique to evaluate hypothalamic inflammation. Univariate and multivariate logistic regression analysis was used to find the influencing factors of depressive disorder. The prediction equation's sensitivity and specificity for the depressive disorder were calculated based on the receiver operating characteristic (ROC) curve.
In young patients with obesity and diabetes, the incidence of depression is 79.49%, which was much higher than that in patients without diabetes (P<0.001). The SI of the left H/A in young patients with obesity and diabetes is significantly higher than that in non-diabetic patients (P<0.001). The relative risks of depression are fasting blood glucose (FBG) (OR 1.60; CI: 1.26-2.05), HbA1c (OR 1.94; CI: 1.40-2.68) and triglycerides (OR 1.40; CI: 1.03-1.90). Only FBG enters the predictive equation for depressive disorder, with a 52.8% sensitivity and 84.5% specificity.
In young diabetic patients with obesity, the incidence of depressive disorder is high, a mechanism possibly related to the left hypothalamus inflammation. Elevated FBG can be an independent predictor of depressive disorder in young patients with obesity.
探讨2型糖尿病（T2DM）对肥胖年轻患者下丘脑炎症和抑郁障碍的影响。
根据T2DM诊断标准，将所有肥胖患者分为糖尿病组和非糖尿病组。采用自评抑郁量表（SDS）评估抑郁障碍的严重程度。运用定量磁共振成像（MRI）技术测量下丘脑上部/杏仁核（H/A）的T2加权相的信号强度（SI）比值，以评估下丘脑炎症。采用单因素和多因素逻辑回归分析来寻找抑郁障碍的影响因素。基于受试者工作特征（ROC）曲线计算预测方程对抑郁障碍的敏感性和特异性。
肥胖合并糖尿病的年轻患者中，抑郁症的发生率为79.49%，远高于无糖尿病患者（P<0.001）。肥胖合并糖尿病的年轻患者左侧H/A的SI显著高于非糖尿病患者（P<0.001）。抑郁的相对风险因素为空腹血糖（FBG）（OR 1.60；CI：1.26 - 2.05）、糖化血红蛋白（HbA1c）（OR 1.94；CI：1.40 - 2.68）和甘油三酯（OR 1.40；CI：1.03 - 1.90）。只有FBG进入抑郁障碍的预测方程，敏感性为52.8%，特异性为84.5%。
肥胖的年轻糖尿病患者中，抑郁障碍的发生率较高，其机制可能与左侧下丘脑炎症有关。空腹血糖升高可能是肥胖年轻患者抑郁障碍的独立预测因素。
