2型糖尿病肥胖患者焦虑状态的观察

目的 探讨T2DM肥胖患者焦虑状态的发生情况及其相关危险因素.方法 采用焦虑自评量表（SAS）评价T2DM肥胖患者120例（O-T2DM组）及T2DM非肥胖患者（T2DM组）394例,进行横断面调查.结果 O-T2DM组标准化焦虑评分为（41.0±14.0）分、焦虑状态者40.0％,高于T2DM组（37.3±12.4）分和30.2％（P=0.005,0.045）.与T2DM组比较,O-T2DM组年龄[（54.3±12.5） vs（58.9±10.9）岁],饮食控制差,脑血管病、高血压病、糖尿病慢性肾脏疾病（CKD）患病率高,血糖[FPG（8.8±3.0）vs（8.0±2.9）mmol/L、2 hPG（13.1±4.7）vs（11.6±4.6）mmol/L]、HbA1c[（8.2±1.8）％vs（7.6±1.7）％]、血压、TG均升高.T2DM肥胖患者标准化焦虑评分与年龄、DBP呈正相关（r=0.181、0.356,P＜0.05）;逐步回归分析显示,FPG及DBP升高是肥胖T2DM患者焦虑的独立危险因素.结论 T2DM肥胖患者年龄小,心脑血管病发病率高,血糖,BP、血脂、饮食控制差,焦虑状态更严重,FPG及DBP升高是T2DM肥胖患者焦虑的独立危险因素.

Obese type 2 diabetes mellitus patients have more severe anxiety status

Objective To investigate the incidence and the risk factors for anxiety in obese and nonobese T2DM patients,for improving its prevention and management.Methods SAS （Self-rating anxiety scale） were used to evaluate the anxiety in 120 obese T2DM patients（O-T2DM group） and 394 non-obese T2DM patients（T2DM group）who visited outpatients clinic at the same period during June 2011 to May 2012.Results Both the incidence and the standard score of anxiety were higher in O-T2DM group than in T2DM group [Incidence,40.0％ vs 30.2％; Score,（41.0 ± 14.0） vs （37.3± 12.4）,P＜0.05].The O-T2DM group had younger age[（54.3 ± 12.5） vs （58.9 ± 10.9） years],poor diet control,higher incidence of cerebrovascular disease,hypertension and chronic kidney disease （CKD） in diabetes,as well as higher blood glucose [FPG,（8.8±3.0） vs （8.0±2.9）mmol/L; 2 hPG,（13.1±4.7） vs （11.6±4.6）mmol/L; HbA1c,（8.2 ± 1.8） ％ vs （7.6 ± 1.7） ％],blood pressure and triglyceride.Female patients ratio,education level,cerebrovascular disease,hypertension were significantly different between obese T2DM with versus without anxiety groups.The standard score of anxiety was positively correlated with age and diastolic blood pressure,whereas negatively correlated with ABI in obese T2DM patients.With the logistic regression analysis,higher diastolic blood pressure was the risk factor for the anxiety in obese T2DM patients.Conclusion The anxiety incidence of obese T2DM patients is higher.Obese T2DM patients are younger,with severe anxiety,poor diet control,higher blood glucose,higher blood pressure,hyperlipidemia,higher prevalence of cardiovascular and cerebrovascular diseases.Higher fasting blood glucose and diastolic blood pressure are the risk factors for anxiety in obese T2DM patients.