首发未用药抑郁症患者抗抑郁治疗6周后胰岛素水平的临床研究

目的探索首发未用药抑郁症患者抗抑郁治疗6周后胰岛素水平变化。方法选取本院2012年1月~12月门诊就诊的81例抑郁症患者为研究对象,另选100例健康对照人群为对照组。所有抑郁症患者随机分配服用盐酸舍曲林或文拉法辛。测定患者抑郁症状、BMI、空腹血糖和胰岛素水平。结果抑郁症患者空腹胰岛素水平和HOMA-β均低于健康对照(P均<0.05),经6周抗抑郁药物治疗后表现出了胰岛素水平和HOMA-β升高趋势。结论抗抑郁药物可独立的影响胰岛素分泌,今后我们将进一步研究长期应用抗抑郁药物对体内糖-胰岛素平衡的影响。

The clinical study of insulin level change after six weeks antidepressant therapy in drug-naive major depressive patients

Objective To investigate the insulin level change after six weeks antidepressant therapy in drug-naive major depressive patients. Methods This study included 100 healthy people （control group） and 81 drug-naive MDD patients diagnosed according to the DSM-IV criteria from January to December 2012. All MDD patients were randomly assigned to receive sertraline or venlafaxine. Depressive symptoms, body mass index, fasting plasma levels of glucose and insulin were measured. Results Compared to the healthy controls, the fasting plasma insulin and the homeostasis model of assessment for pancreatic β-cell secretory function （HOMA-β） were signicantly lower in the MDD patients before antidepressant treatment （P all〈0.05）. The drug-naive MDD patients with six weeks of antidepressant treatment had the tendency to exhibit increases in both the insulin level and HOMA-β index. Conclusion Antidepressants might affect insulin secretion independently of the therapeutic effects on MDD. Further studies are needed to investigate the long-term effects of antidepressants on insulin regulation in MDD patients.