Fang Xue-E, Chen Dan-Ping, Tang Ling-Ling, Mao Yan-Jun
Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China.
Department of Nursing, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China.
World J Clin Cases. 2022 May 16;10(14):4395-4403. doi: 10.12998/wjcc.v10.i14.4395.
Depression has been reported to be prevalent in patients with pulmonary tuberculosis (PTB). Moreover, several clinical symptoms of PTB and depression overlap, such as loss of appetite and malnutrition. However, the association between depression and malnutrition in TB patients has not been fully elucidated.
To explore the association between depression and malnutrition in patients with PTB.
This hospital-based cross-sectional study included patients with PTB in Shanghai Pulmonary Hospital Affiliated to Tongji University from April 2019 to July 2019. The Patient Health Questionnaire-9 (PHQ-9) scale was used to evaluate depre-ssion. The cut-off value was set at 10, and the nutritional state was determined by the body mass index (BMI). In addition, the Quality of Life Instruments for Chronic Diseases was employed to establish the quality of life (QOL). Univariable analysis and multivariable analysis (forward mode) were implemented to identify the independent factors associated with depression.
A total of 328 PTB patients were screened for analysis. Eight were excluded for missing demographic data, four excluded for missing nutrition status, and sixteen for missing QOL data. Finally, 300 PTB patients were subjected to analysis. We found that depressive state was present in 225 PTB patients (75%). The ratio of malnutrition in the depressive PTB patients was 45.33%. Our results revealed significantly lower BMI, hemoglobin, and prealbumin in the depression group than in the control group ( < 0.05). Moreover, the social status differed significantly ( < 0.05) between the groups. In addition, glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in the depression group were significantly higher than those in the control group ( < 0.05). Multivariable logistic regression analysis showed that BMI [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.163-1.257, < 0.001] and poor social function (OR = 0.95, 95%CI: 0.926-0.974, = 0.038) were independently associated with depression.
Malnutrition and poor social function are significantly associated with depressive symptoms in PTB patients. A prospective large-scale study is needed to confirm these findings.
据报道，抑郁症在肺结核（PTB）患者中普遍存在。此外，PTB的一些临床症状与抑郁症重叠，如食欲不振和营养不良。然而，结核病患者中抑郁症与营养不良之间的关联尚未完全阐明。
探讨PTB患者抑郁症与营养不良之间的关联。
这项基于医院的横断面研究纳入了2019年4月至2019年7月在同济大学附属上海市肺科医院的PTB患者。采用患者健康问卷-9（PHQ-9）量表评估抑郁症。临界值设定为10，并通过体重指数（BMI）确定营养状况。此外，使用慢性病生活质量量表来确定生活质量（QOL）。进行单变量分析和多变量分析（向前模式）以确定与抑郁症相关的独立因素。
共筛选出328例PTB患者进行分析。8例因人口统计学数据缺失被排除，4例因营养状况数据缺失被排除，16例因QOL数据缺失被排除。最终，对300例PTB患者进行分析。我们发现225例PTB患者（75%）存在抑郁状态。抑郁的PTB患者中营养不良的比例为45.33%。我们的结果显示，抑郁症组的BMI、血红蛋白和前白蛋白显著低于对照组（P<0.05）。此外，两组之间的社会状况存在显著差异（P<0.05）。此外，抑郁症组的谷丙转氨酶和谷草转氨酶显著高于对照组（P<0.05）。多变量逻辑回归分析显示，BMI[比值比（OR）=1.21，95%置信区间（CI）：1.163-1.257，P<0.001]和社会功能差（OR=0.95，95%CI：0.926-0.974，P=0.038）与抑郁症独立相关。
营养不良和社会功能差与PTB患者的抑郁症状显著相关。需要进行前瞻性大规模研究来证实这些发现。
