维生素D缺乏与2型糖尿病合并抑郁状态的相关性

doi:10.6040/j.issn.1671-7554.0.2021.0296

摘要/Abstract

摘要： 目的探讨维生素D缺乏与2型糖尿病(T2DM)合并抑郁的相关性。方法选取T2DM患者175例,根据抑郁自评量表(SDS)评分将患者分为抑郁组(n=74)与非抑郁组(n=101),检测血清25-羟基维生素D(25OHD)浓度,应用双能X线分析仪检测骨密度,比较两组25OHD、骨密度的差异,采用Spearman相关分析评价血清维生素D水平与SDS评分的相关性,对于单因素分析中P值较小的变量进行多因素Logistic回归分析,绘制受试者操作特征曲线(ROC)并计算曲线下面积(AUC)来评价维生素D缺乏及骨密度对于T2DM合并抑郁的诊断价值。结果抑郁组血清25OHD水平明显低于非抑郁组,抑郁组骨密度包括股骨颈、全髋、腰椎L_1-4骨密度亦低于非抑郁组,差异有统计学意义(P<0.05);抑郁组维生素D缺乏、骨质疏松症患病率均高于非抑郁组,差异有统计学意义(P<0.05)。血清25OHD及骨密度与SDS评分呈负相关,二元Logistic回归分析结果显示维生素D缺乏(OR: 8.748,95%CI: 1.724~44.375, P=0.009)、骨质疏松症(OR: 6.385,95%CI: 2.358~17.291, P<0.001)是T2DM合并抑郁的可能影响因素。结论维生素D缺乏可能是T2DM合并抑郁症的危险因素,提示积极防治维生素D缺乏有助于改善T2DM患者的抑郁状态。

关键词: 维生素D, 抑郁, 骨质疏松症, 2型糖尿病

Abstract: Objective To investigate the correlation between vitamin D deficiency and depression in patients with type 2 diabetes mellitus(T2DM). Methods A total of 175 T2DM patients were selected and divided into the depression group(n=74)and non-depression group(n=101)according to the Self-Rating Depression Scale(SDS). Serum concentration of 25OHD was measured. Bone mineral density was measured with dual energy X-ray. The differences in 25OHD and BMD between the two groups were compared. The correlation between serum vitamin D level and SDS score was evaluated with Spearman correlation analysis. Multivariate Logistic regression analysis was performed for the variables with small P value in univariate analysis. The receiver operating characteristic curve(ROC)was drawn and the area under the curve(AUC)was calculated to evaluate the diagnostic value of vitamin D deficiency and bone mineral density in T2DM patients with depression. Results The serum level of 25OHD and bone mineral density of femoral neck, hip joint and lumbar 1-4 in the depression group were significantly lower than those in the non-depression group(P<0.05). The prevalence of vitamin D deficiency and osteoporosis in the depression group were higher than those in the non-depression group(P<0.05). Logistic regression analysis showed that vitamin D deficiency(OR: 8.748, 95%CI: 1.724-44.375, P=0.009)and osteoporosis(OR: 6.385, 95%CI: 2.358-17.291, P<0.001)were influencing factors of T2DM complicated with depression. Conclusion Vitamin D deficiency may be a risk factor of T2DM patients with depression. Active prevention and treatment of vitamin D deficiency may help improve the depressive state of T2DM patients.

Key words: Vitamin D, Depression, Osteoporosis, Type 2 diabetes mellitus

中图分类号:

R587.2

刘萍,宋玉文,王萍,田光伟,郑凤杰,吕丽,杜娇娇,张静,庄向华,陈诗鸿. 维生素D缺乏与2型糖尿病合并抑郁状态的相关性[J]. 山东大学学报 (医学版), 2021, 59(6): 51-56.

LIU Ping, SONG Yuwen, WANG Ping, TIAN Guangwei, ZHENG Fengjie, LYU Li, DU Jiaojiao, ZHANG Jing, ZHUANG Xianghua, CHEN Shihong. Correlation between vitamin D deficiency and depression in patients with type 2 diabetes mellitus[J]. Journal of Shandong University (Health Sciences), 2021, 59(6): 51-56.

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