2 型糖尿病患者中抑郁和焦虑的患病率增加与血糖波动和睡眠质量有关。
The increased prevalence of depression and anxiety in T2DM patients associated with blood glucose fluctuation and sleep quality.
机构信息
Department of Endocrinology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China.
Department of Hospital Infection Control, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, Guangdong, China.
出版信息
BMC Endocr Disord. 2022 Sep 17;22(1):232. doi: 10.1186/s12902-022-01147-8.
BACKGROUND
Current evidence demonstrates that blood glucose fluctuation can be associated with depression and anxiety. The association among blood glucose fluctuation, traditional risk factors and emotional disorders in T2DM should be studied and clarified.
METHODS
A total of 182 diabetic patients including 81 patients with depression or anxiety and 101 patients without emotional disorder were enrolled into this study. Data were obtained through medical history and questionnaire survey. Data were analyzed using appropriate statistical methods.
RESULTS
The comparison results of basic information between the two groups showed that the differences of the proportion of female were statistically significant (p = 0.002). There was no statistical difference in laboratory examination indexes between the two groups, however, standard deviation of blood glucose (SDBG) and postprandial glucose excursion (PPGE) of the comorbidity group were significantly higher than that of control group (p = 0.032 and p = 0.037). The results of questionnaire survey showed that there were statistically significant differences in sleep quality, PSQI and dietary habit between the two groups (p < 0.001, p < 0.001 and p < 0.001). Stratified analysis results according to gender showed that the percentage of cognitive disorder, anxiety and depression in female group was significantly higher than that in male group (p = 0.001, p < 0.001 and p < 0.001). Mini-mental state examination (MMSE), self-rating anxiety scale (SAS) and patient health questionnaire (PHQ-9) score in female group were also higher than male group (p = 0.001, p < 0.001 and p < 0.001). Logistic regression analysis results showed that SDBG and sleep quality were associated with emotional disorders in T2DM (p = 0.040 and p < 0.001) and the OR values of these factors were 7.588 (1.097-52.069) and 4.428 (2.649-7.401).
CONCLUSIONS
Blood glucose fluctuation and sleep quality are associated with the increased prevalence of depression and anxiety disorders in T2DM.
背景
现有证据表明，血糖波动可能与抑郁和焦虑有关。应研究和阐明 T2DM 中血糖波动、传统危险因素与情绪障碍之间的关系。
方法
共纳入 182 例糖尿病患者，其中抑郁或焦虑 81 例，无情绪障碍 101 例。通过病历和问卷调查收集资料，采用合适的统计学方法进行数据分析。
结果
两组间基本信息比较结果显示，女性比例差异有统计学意义（p=0.002）。两组间实验室检查指标无统计学差异，但合并症组的血糖标准差（SDBG）和餐后血糖波动（PPGE）显著高于对照组（p=0.032 和 p=0.037）。问卷调查结果显示，两组间睡眠质量、PSQI 和饮食习惯差异有统计学意义（p<0.001、p<0.001 和 p<0.001）。按性别分层分析结果显示，女性组认知障碍、焦虑和抑郁的比例明显高于男性组（p=0.001、p<0.001 和 p<0.001）。女性组的简易精神状态检查（MMSE）、焦虑自评量表（SAS）和患者健康问卷（PHQ-9）评分也高于男性组（p=0.001、p<0.001 和 p<0.001）。Logistic 回归分析结果显示，SDBG 和睡眠质量与 T2DM 情绪障碍相关（p=0.040 和 p<0.001），这些因素的 OR 值分别为 7.588（1.097-52.069）和 4.428（2.649-7.401）。
结论
血糖波动和睡眠质量与 T2DM 中抑郁和焦虑障碍的患病率增加有关。
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