2型糖尿病患者抑郁的患病率及相关危险因素分析

目的 调查2型糖尿病患者抑郁的患病率,分析与抑郁相关的危险因素.方法 2966例2型糖尿病患者,其中男姓1 463例,女性1 503例,年龄(56.4±11.2)岁,病程(6.3±5.7)年.用Beck抑郁问卷(BDI)进行抑郁评分进行分组,抑郁标准:≤4分,非抑郁组;5～13分,轻度抑郁组;14 ～20分,中度抑郁组;21分或更高,重度抑郁组.同时收集年龄、性别、体重指数、病程、相关生化代谢指标及与糖尿病有关的一般资料(如吸烟史、糖尿病教育、治疗等).计算抑郁的患病率,用logistic回归筛选抑郁的危险因素.结果 51％的患者存在不同程度抑郁症,其中轻度抑郁占38％,中度8％,重度5％.与非抑郁组相比,抑郁组患者中女性性别、合并周围神经病变、接受糖尿病教育及使用胰岛素治疗者比例高(P＜0.01),年收入大于20000元者比例低(P＜0.01).重度抑郁组中吸烟者比例较高,年龄偏低(P＜0.05).偏相关分析显示2型糖尿病患者,抑郁与女性性别、糖尿病教育、合并周围神经病变成正相关,与年龄成负相关(P＜0.05).条件logistic回归方程显示女性性别(OR=1.37),年龄(20～40岁,OR=1.52),糖尿病教育(OR=1.51),周围神经并发症(OR=1.87),均为抑郁发生的危险因素.结论 抑郁在2型糖尿病患者中普遍存在,临床实践中应重视对抑郁的筛查.

Prevalence of depression and its risk factors in type2 diabetes mellitus

Objective To investigate the prevalence of depression and its risk factors in type 2 diabetes mellitus.Methods Beck Depression Inventory (BDI) was used to evaluate depression in 2 966 type 2 diabetes mellitus patients male 1 463,female 1 503,age ( 56.4 ± 11.2 ) years,diabetes duration ( 6.3 ± 5.7 ) years ].Depression criteria:≤4 points,no depression group; 5-13 points,mild depression group; 14-20 points,moderate depression group; 21 points or higher,severe depression group.Meanwhile,the demographic and metabolic data and diabetes-related health behaviors were also investigated.The risk factors associated with depression were screened by logistic regression.Results 51％ patients had depression,including 38％ with mild,8％ with moderate,and 5％ with severe depression.Compared with no depression group,depression was correlated with female sex,low-annual income,diabetes education,diabetes treatment,with insulin and peripheral neuropathy( P＜0.01 ).More smoking and younger age were found in severe depression( P＜0.05 ).Partial correlation analysis showed that depression in type 2 diabetes mellitus was positively correlated with female sex,diabetes education,and peripheral neuropathy ; and negatively correlated with age (P＜0.05).Conditional logistic regression equation showed that gender( OR =1.37 ),age ( 20-40 years,OR =1.52 ),diabetes education ( OR =1.51 ),and peripheral neuropathy ( OR =1.87 ) were risk factors for depression.Conclusion Depression is common in type 2 diabetes mellitus.More attention should be paid to screening depression in clinical practice.